Belsey and Nissen Operations for Gastresophageal Reflux

Abstract

From 1972 to 1985, 37 consecutive patients underwent primary Belsey repair and 40 consecutive patients underwent primary Nissen fundoplication because of reflux disease. The operative procedures were performed by a single surgeon in each group. For the purpose of comparison, both groups were divided into two subsets: (1) patients with proved reflux, and (2) patients with different indications. The first subset consisted of 30 patients in the Belsey series and 32 in the Nissen series. The remaining patients were included in the second subset. One death occurred in the Belsey series; morbidity consisted of minor pulmonary complications in the Belsey series (10.8%) and spleen injuries requiring splenectomy (5%) in the Nissen series. In patients with proved reflux good-to-excellent results were achieved in 89.3% of subjects of the Belsey series and 86.6% of patients of the Nissen group. The failures rates were 7.1% and 10%, respectively. Inability to vomit and/or belch was reported in 7.1% of patients with proved reflux of the Belsey group and 10% of patients with proved reflux of the Nissen group. In patients with different indications there were no failures after either operation. Finally 82.2% of subjects in the Belsey group and 73.3% of patients in the Nissen group declared that they were satisfied with the operative results. In conclusion the Belsey and the Nissen procedures are equally able to achieve long-term control of reflux disease in comparable groups of patients. Failures and gastrointestinal symptoms are equally frequent after either procedure and do not affect the overall patient acceptance of antireflux surgery.

Laparoscopic Nissen fundoplication is less expensive than open Belsey Mark IV

“…Readmission for chylothorax ferred open procedure for GERD at Emory University Hospital was a B4. Published studies support B4 as a comparable operation to Nissen fundoplication: both operations having a roughly 90% success rate in treating GERD [12,[15][16][17].…”

Die anteriore Semifundoplicatio zur Behandlung der gastroösophagealen Refluxkrankheit

“…Insgesamt waren 60 (77,9%) der Patienten mit dem Ergebnis der Operation zufrieden, was ebenfalls den Ergebnissen nach Fundoplicatio entspricht (73,3% -Stipa et al [25]). Unter den weniger zufriedenen waren 4 Kranke, bei denen eine Narbenhernie operativ beseitigt werden musste, ein Problem, das sich mit Anwendung der laparoskopischen Technik verringern dürfte.…”

Minimally Invasive Surgical Techniques for the Treatment of Gastroesophageal Reflux Disease

“…However, pulmonary complications are more common after a thoracic operation than after transabdominal surgery. Also, postoperative morThe Nissen fundoplication in which the fundus is totally wrapped around the lower esophagus can be easily bidity is higher with a longer time before returning to work [34,45]. The laparoscopic route has also emerged performed laparoscopically in the conventional fashion [2,38].…”

“…Good quality of life scores and high satisfaction rates required and =5% of patients experience persistent dysphagia more than 6 months after surgery [19,26, in patients after conventional antireflux surgery have been shown [25,45,58]. Early results after laparoscopic antire-48, 51,65].…”

“…Some report on better results on gas bloat after the Toupet fundoplication and Belsey Mark IV antireflux but should at least be as good as with the open procedures and superior to medical therapy. The laparoscopic procedures [10,31,45]. Gas-binding agents and prokinetics are helpful when patients complain of bloating and approach is effective in allowing the procedure to be performed accurately with all of the advantages of minimally increased flatulence.…”