Abstract | OBJECTIVE: METHODS: From January 1978 to October 1998, 64 patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and antireflux operation via left thoracotomy. Twenty-one patients underwent Nissen total fundoplication (Nissen group) and 43 patients underwent Belsey Marker IV partial fundoplication (Belsey group). Clinical, radiologic, radionuclide transit, manometric, 24-hour pH monitoring and endoscopic assessments were performed before and after the operation. RESULTS: There was no operative death and major complications for either group. At over 6 years follow-up and compared to Belsey group, patients in Nissen group revealed a higher frequency of dysphagia (P = 0.025) and more radionuclide material retention (P = 0.044). Both operative procedures reduced the lower esophageal sphincter pressure gradient. However, in Nissen group, the esophageal diameter observed on radiology was significantly increased from 3.9 cm preoperatively to 5.5 cm postoperatively (P = 0.012), while it kept the same for Belsey group (from 5.4 to 5.3 cm, P = 0.695). Reoperation in order to relieve the recurrent dysphagia and esophageal obstruction was performed on 8 patients in Nissen group and 1 in Belsey group (P < 0.01). CONCLUSION:
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Authors | Zi-jiang Zhu, Long-qi Chen, Andre Duranceau |
Journal | Zhonghua wai ke za zhi [Chinese journal of surgery]
(Zhonghua Wai Ke Za Zhi)
Vol. 46
Issue 4
Pg. 289-92
(Feb 15 2008)
ISSN: 0529-5815 [Print] China |
PMID | 18683768
(Publication Type: Comparative Study, English Abstract, Journal Article)
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Topics |
- Adult
- Esophageal Motility Disorders
(surgery)
- Esophagus
(surgery)
- Female
- Follow-Up Studies
- Fundoplication
(methods)
- Humans
- Male
- Middle Aged
- Treatment Outcome
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