The gastroplasty tube as a method of reflux control

Follow-up of 135 patients who underwent Belsey gastroplasty because of intractable reflux demonstrated that 44% had continued reflux and 25% had symptoms of reflux that were serious, despite a very low rate of anatomic recurrence. Most of the patients with symptomatic reflux had major preexisting esophageal pathologic conditions related to previous surgery, esophageal ulceration, stricture, or scleroderma. In this group Belsey gastroplasty was not an effective method of reflux control. Total fundoplication gastroplasty (TFG) in 100 consecutive patients has so far had the same low rate of anatomic recurrence, most likely related to the gastroplasty tube; however, longer follow-up is necessary to confirm this fact. TFG is effective in controlling reflux; none of the 100 patients so treated had clinical or radiologic evidence of reflux on follow-up examination.