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A new balanced operation for complex gastroesophageal reflux disease
R J Landreneau1, J B Marshall, J A Johnson
1Division of Cardiothoracic Surgery, University of Missouri School of Medicine, Columbia.
The Annals of Thoracic Surgery
|August 1, 1991
Summary
Combined transthoracic parietal cell vagotomy and Collis-Nissen fundoplication effectively treated advanced gastroesophageal reflux disease. This surgical approach significantly reduced gastric acid output and provided lasting symptom relief for 96% of patients.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Acid Reflux Management
Background:
- Advanced gastroesophageal reflux disease (GERD) poses significant challenges.
- Current treatments may not always provide complete or lasting symptom relief.
Purpose of the Study:
- To evaluate the efficacy of combined transthoracic parietal cell vagotomy and Collis-Nissen fundoplication for advanced GERD.
- To assess the impact on gastric acid output and long-term symptom control.
Main Methods:
- A cohort of 27 patients with advanced GERD underwent the combined surgical procedure.
- Gastric acid output was measured preoperatively and 6 months postoperatively in 20 patients.
- Patient outcomes and symptom relief were monitored for a mean of 13.3 months.
Main Results:
- A significant late reduction in gastric acid output was observed postoperatively.
- 96% of patients (26 out of 27) experienced relief from GERD symptoms.
- No significant post-vagotomy symptoms were reported in the treated patients.
Conclusions:
- Combined transthoracic parietal cell vagotomy and Collis-Nissen fundoplication is an effective treatment for advanced GERD.
- This surgical combination offers a potential adjunct for mechanical control of severe acid reflux.
- The procedure demonstrates a favorable safety profile with high symptom relief rates.