The surgical treatment of reflux oesophagitis: results of surgical repair over a 12-year period.

Abstract

Abstract The results of surgical treatment of 81 cases of reflux oesophagitis during the period 1958–70 are reported. From 1958 to 1966 a simple repair, i.e. repair of the hiatus and reconstruction of the oesophagogastric angle, was done. From 1966 to 1970 a fundoplication was substituted. About half of the cases with simple repairs also had vagotomy and pyloroplasty, and some had cholecystectomy for associated gallstones. Of the entire series, 92 per cent had a good clinical result and 78 per cent were good radiologically. Comparing simple repair with fundoplication, 92 per cent of the cases in both groups were good clinically, but radiologically 97 per cent of the fundoplications were good compared with 60 per cent of the simple repairs. Two of 44 simple repairs have required further surgery for recurrent oesophagitis. There has been no recurrent oesophagitis in the fundoplication group, but dysphagia has been a problem requiring reoperation in I case and repeated bouginage in 3 others. Postprandial discomfort due to dificulty in belching occurs. Vagotomy has not had a beneficial effect, the group without vagotomy being superior both clinically and radiologically. To conclude, simple repair by the abdominal route has given good clinical results in 92 per cent of 44 patients followed for 6–12 years. Neither fundoplication nor vagotomy has improved these results and both can add complications.