Outcome effect of adherence to operative principles of Nissen fundoplication by multiple surgeons

Gary L. Dunnington, Tom R. DeMeester, of Veterans Affairs Gastroesophageal Reflux Disease Study Group Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

Fifty-eight patients participated in a multi-institutional study designed to assess the outcome of Nissen fundoplication when performed for complicated disease by a variety of surgeons with varied skill and experience with compliance to established technical principles. All patients had an abnormal 24-hour pH study and mucosal injury on endoscopy. The surgical procedures were performed in 8 Veterans Administration hospitals by surgical residents supervised by surgical faculty, after initial agreement on 10 operative principles for the Nissen fundoplication. The mean symptomatic scores at 52 and 104 weeks improved significantly compared with the preoperative score (p<0.0001). There was significant improvement in total percent time at pH below 4 at 52 weeks (p<0.01) and 104 weeks (p<0.01). There was significant improvement in the grade of esophagitis at 1 year (p<0.0001). Compliance was greater than 90% for 7 of 10 principles of repair. In conclusion, a Nissen fundoplication resulted in relief of symptoms in 93% of patients and a 77% rate of healing of esophagitis. These results in complicated reflux disease were achieved by a variety of surgeons with varied experience in antireflux surgery.

Original languageEnglish (US)
Pages (from-to)654-658
Number of pages5
JournalThe American Journal of Surgery
Volume166
Issue number6
DOIs
StatePublished - Dec 1993
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Dunnington, G. L., DeMeester, T. R., & Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group, O. V. A. G. R. D. S. G. (1993). Outcome effect of adherence to operative principles of Nissen fundoplication by multiple surgeons. The American Journal of Surgery, 166(6), 654-658. https://doi.org/10.1016/S0002-9610(05)80673-7