An alternative fundoplicative maneuver for gastroesophageal reflux

Twenty-two patients with gastroesophageal reflux undergoing an original antireflux operative procedure are presented. The mean time between operation and follow-up was 19 months. The technique consists of a semifundoplicative maneuver with firm intraabdominal fixation of the esophagus by suturing the fundoplication to the diaphragm. There was no mortality. The patients were free of reflux symptoms and complications, and the standard reflux test was negative in all cases. All patients had postoperative lower esophageal sphincter pressure within the normal range. The phenomenon of gas-bloat as not observed, nor was inability to vomit or belch. These results confirm the observations made earlier in a series of 110 patients operated on with the same method. A long-term prospective randomized study is in progress, with the aim of comparing the technique described herein and the Nissen fundoplication.