[Posterior fundoplication of 270 degrees. pH results after one and 5 years]

This prospective study compared pre- and postoperative pH monitoring one and five years after a 270 degrees posterior fundoplication. Thirty-six consecutive patients with gastroesophageal reflux were included over a period of 3 years. All patients had preoperative esophagoscopy and 3 hour post-prandial pH monitoring. Thirty-three patients had esophagitis. At one year follow-up, pH monitoring was performed in 31 patients and esophagoscopy in 29. At five years, 23 patients accepted a new pH control. Appraisal of efficacy was assessed by Kaye's acid reflux score (normal < or = 90) and the percentage of time (t) below pH 5 (normal < or = 10%). Among the 23 patients who were submitted 3 times to pH monitoring, Kaye's acid reflux score evolved from 149 (+/- 68) before fundoplication to 1.1 (+/- 2) and 16 (+/- 29) after one and five years respectively. The value of t decreased from 20% (+/- 16) to 0.4% (+/- 0.8) after one year and to 2.5% (+/- 3) after five years. The 270 degrees posterior valve corrects pH recordings at one year. Its efficacy remained steady after 5 years, although there was a slight increase in acid reflux scores. The mean value of these scores was always within normal limits.