Can recurrent reflux disease after fundoplication be circumvented by adding a vagotomy?

Gastro-esophageal reflux disease (GORD) is caused by a weak lower esophageal sphincter. Open Nissen fundoplication has been the most common surgical treatment of GORD and hiatus hernia. This paper describes the symptomatic result and quantifies the endoscopic improvement achieved by open Nissen fundoplication alone and when combined with truncal vagotomy in a series of 21 cases and studies whether the added vagotomy confers any additional benefits. From the results, it was concluded that, compared with fundoplication alone, an additional vagotomy does seem to prevent recurrent reflux disease. Therefore, in the absence of any contraindication, it is strongly recommended to combine a vagotomy(and if necessary a drainage procedure) with a Nissen fundoplication for the surgical treatment of GORD and hiatus hernia.