270-DEGREES POSTERIOR FUNDOPLICATION - PO STOPERATIVE PH RESULTS AT 1AND 5 YEARS

This prospective study compared pre- and postoperative pH monitoring o ne and five years after a 270-degrees posterior fundoplication. Thirty -six consecutive patients with gastroesophageal reflux were included o ver a period of 3 years. All patients had preoperative esophagoscopy a nd 3 hour post-prandial pH monitoring. Thirty-three patients had esoph agitis. At one year follow-up, pH monitoring was performed in 31 patie nts and esophagoscopy in 29. At five years, 23 patients accepted a new pH control. Appraisal of efficacy was assessed by Kaye's acid reflux score (normal less-than-or-equal-to 90) and the percentage of time (t) below pH 5 (normal less-than-or-equal-to 10 %). Among the 23 patients who were submitted 3 times to pH monitoring, Kaye's acid reflux score evolved from 149 (+/- 68) before fundoplication to 1.1 (+/-2) and 16 (+/- 29) after one and five years respectively. The value of t decreas ed from 20 % (+/- 16) to 0.4 % (+/- 0.8) after one year and to 2.5 % ( +/- 3) after five years. The 270-degrees posterior valve corrects pH r ecordings at one year. Its efficacy remained steady after 5 years, alt hough there was a slight increase in acid reflux scores. The mean valu e of these scores was always within normal limits.