The long term results of open antireflux surgery in a community-based health care center

OBJECTIVE: There is no previous study concerning long term results of open Nissen fundoplication performed by general surgeons in a nonspecialized uni t. METHODS: Of 45 consecutive patients in a general provincial center, 39 were available for follow-up after a mean period of 78 months. All patients wer e interviewed using a standard questionnaire, and 35 of them consented to u ndergo endoscopy. RESULTS: Of the patients, 85% had no or only mild reflux symptoms. The figu res for dysphagia, flatulence, and bloating were 31%, 67%, and 46%, respect ively. Endoscopy showed defective fundic wrap in 37% of the patients and er osive esophagitis in 29%. Five patients (13%) with recurrent esophagitis we re referred for H2-blocker or omeprazole medication, and five others (13%) were scheduled for repeat antireflux surgery. CONCLUSIONS: The results were somewhat worse in regard to prevalence of def ective fundic wrap and recurrent esophagitis than in other reports, which w ere from specialized units. (Am J Gastroenterol 1999;94:1777-1781. (C) 1999 by Am. Coll. of Gastroenterology).