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Ann Thorac Surg 1982;33:534-539
© 1982 The Society of Thoracic Surgeons

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Articles

The Combined Collis-Nissen Operation: Early Assessment of Reflux Control

From the Department of Surgery, Section of Thoracic Surgery, The University of Michigan Medical Center, Ann Arbor, MI

^* Address reprint requests to Mark B. Orringer, M.D., Section of Thoracic Surgery, C7079, Box 32, University Hospital, Ann Arbor, MI 48109

This report summarizes the clinical experience with 155 patients who underwent the Collis-Nissen operation and have been followed by personal interview, esophageal manometry, barium swallow examination, and acid reflux testing for up to three years (average, 24 months). There has been 1 postoperative death. Major complications have included gastroplasty tube leak (2 patients), stricture perforation during dilation (1 patient), and splenic injury (3 patients).

Subjectively, among 135 patients followed for a minimum of 6 months, reflux has been eliminated in 89% (120 patients), remains mild in 6% (8 patients), and is severe in 5% (7 patients). Early satiety ("bloats") of varying degree has occurred in 19% (26 patients), and dysphagia requiring dilation in 15% (20 patients). The overall objective recurrence rate, as documented with the intraesophageal pH probe and the standard acid reflux test, is 13% (18 patients). Among 32 patients with peptic strictures treated with dilation and the Collis-Nissen operation, reflux symptoms have recurred in 3%, and 6% have had abnormal reflux demonstrated with the pH probe.

These results substantiate excellent early reflux control with the Collis-Nissen procedure and justify its continued use in appropriately selected patients with gastroesophageal reflux and its complications.

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