Uncut Collis-Nissen fundoplication: learning curve and long-term results

Area of Science:

• Gastroenterology
• Surgical Procedures
• Medical Device Technology

Background:

• Review of 100 consecutive patients undergoing primary uncut Collis-Nissen fundoplication between September 1985 and July 1990.
• Analysis of patient demographics, indications for surgery, and pre-operative findings.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of the uncut Collis-Nissen fundoplication.
• To assess the learning curve associated with the procedure.

Main Methods:

• Surgical intervention via left thoracotomy.
• Pre-operative diagnostic assessments including upper GI endoscopy, upper GI series, and motility studies.
• Post-operative follow-up for complications, mortality, and functional outcomes.

Main Results:

• 84% of patients achieved good to excellent long-term functional results.
• Initial patient cohort (first 25) experienced higher complication rates (40%) and mortality (8%) compared to the subsequent 75 patients (17% complications, 0% mortality).
• Median follow-up was 100 months, with 86% of operative survivors alive at last follow-up.

Conclusions:

• The uncut Collis-Nissen fundoplication is an effective procedure for achieving good to excellent long-term outcomes.
• Acceptable operative mortality and morbidity are demonstrated, with a notable learning curve impacting initial results.