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Ann Thorac Surg 1995;60:915-921
© 1995 The Society of Thoracic Surgeons
Division of Thoracic Surgery, Department of Surgery, Université de Montréal, Hótel-Dieu de Montréal, Montréal; Québec, Canada
* Address reprint requests to Dr Duranceau, Department of Surgery, Hótel-Dieu de Montréal, 3840, St-Urbain, Montréal, Québec, Canada H2W T18.
Background.: This study reviewed the short-term results of the uncut Collis-Nissen gastroplasty.
Methods.: From 1990 through 1993, 27 consecutive patients (16 men, 11 women) underwent an uncut Collis-Nissen gastroplasty. Mean age was 59 years (range, 30 to 75 years). Three patients had a previous failed antireflux procedure. Indications for operation were gastroesophageal reflux disease resistant to medical treatment in 18 patients and symptomatic hiatal hernia in 9 patients. Fourteen patients had Barrett's esophagus and 4 had a peptic stricture. Complete esophageal function testing including barium swallow, endoscopy, manometry, and 24-hour pH recording was performed in 26 of 27 patients preoperatively and postoperatively.
Results.: Five patients (19%) had complications, which included atelectasis in 2, cardiac dysrhythmia in 2, and prolonged ileus in 1. There were no operative deaths. Follow-up was complete in all patients and ranged from 8 to 45 months (mean, 22 months). Subjectively, symptoms of reflux were resolved in all patients. Six patients complain of slow esophageal emptying and 3 have occasional episodes of dysphagia. None required postoperative dilation. Ulcers and erosions healed in all 26 patients who underwent endoscopy but recurred in 2 at 21 and 36 months postoperatively. Mean lower esophageal sphineter gradient increased from 8.3 mm Hg preoperatively to 14.6 mm Hg (p = 0.0001). Total percent of acid exposure decreased from 8.0% preoperatively to 1.7% (p = 0.003).
Conclusions.: We conclude that the uncut Collis-Nissen procedure provides acceptable short-term control of gastroesophageal reflux disease.
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