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Related Experiment Videos

Gastroplasty and fundoplication for complex reflux problems. Long-term results.

F G Pearson1, J D Cooper, G A Patterson

  • 1Division of Thoracic Surgery, University of Toronto, Ontario, Canada.

Annals of Surgery
|October 1, 1987
PubMed
Summary

Modified Collis gastroplasty with partial fundoplication effectively manages complex reflux, especially in patients with esophageal shortening. Long-term follow-up shows good outcomes, particularly for those without prior surgery or motor disorders.

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Area of Science:

  • Gastroenterology and Surgical Innovation

Background:

  • Complex reflux problems often involve esophageal shortening, necessitating advanced surgical techniques.
  • Reoperations for failed antireflux procedures present unique challenges.

Purpose of the Study:

  • To evaluate the long-term efficacy of modified Collis gastroplasty and partial fundoplication for complex reflux.
  • To identify patient subgroups that benefit most from this combined surgical approach.

Main Methods:

  • A cohort of 430 patients with complex reflux underwent modified Collis gastroplasty and partial fundoplication between 1964 and 1984.
  • Indications included acquired esophageal shortening (with or without stricture) and massive sliding hiatal hernia.
  • Long-term follow-up (1-20 years) assessed outcomes based on symptom severity and need for therapy.

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Main Results:

  • Overall, 90% of patients (382/430) had complete follow-up.
  • Best outcomes were observed in patients with acquired shortening due to esophagitis (with/without stricture) who had no prior antireflux surgery and no motor disorder.
  • Reoperation cases had a nearly tripled rate of unsatisfactory results (20% fair or poor).
  • Patients with primary motor disorders alongside reflux esophagitis and stricture had approximately 50% good long-term results.

Conclusions:

  • Modified Collis gastroplasty combined with partial fundoplication is a durable solution for complex gastroesophageal reflux disease, particularly in cases of esophageal shortening.
  • Surgical outcomes are significantly influenced by prior antireflux procedures and the presence of esophageal motor disorders.