Open AccessA Long-Term Randomized Prospective Trial of the Nissen Procedure Versus a Modified Toupet Technique
Author(s) -
K Thor,
T Silander
Publication year - 1989
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198912000-00005
Subject(s) - medicine , nissen fundoplication , heartburn , dysphagia , surgery , randomized controlled trial , reflux , endoscopy , prospective cohort study , disease
Thirty-one patients about to undergo surgery for gastroesophageal reflux were randomized into either a Nissen fundoplication group (12) or a modified Toupet semifundoplication group (19). All patients were followed on a long-term basis for 5 years with a standard questionnaire, endoscopy, and manometry. Ninety-five percent of the patients in the modified Toupet group had good or excellent results versus 67% for the Nissen group. However both procedures are effective in curtailing esophagitis with an improvement of the endoscopic grading in the Nissen group by 91% and 89% in the group undergoing the modified Toupet procedure. A significant improvement in symptoms (acid regurgitation, heartburn, retrosternal pain) was noted in both groups, except for dysphagia in the Nissen group. Three patients with a Nissen fundoplication had a slipped Nissen requiring reoperation and two had gas-bloat syndrome. These specific complications of the Nissen procedure were not found in the modified Toupet group.