Prospective study of symptoms and gastro-oesophageal reflux 10 years after posterior partial fundoplication

Background: This was a prospective study of symptoms, and short-term and long-term reflux competence after partial fundoplication. Methods: Some 101 patients were operated consecutively with posterior partial (270 degrees) fundoplication. Indications for surgery were reflux disease without erosive oesophagitis in 25 patients, moderate oesophagitis in;43, severe oesophagitis in 25 and paraoesophageal hernia in eight. Symptom score, manometry and pH tests were performed before operation, 6 months after operation and after 6-14 years. Results: All patients (n=101) were free from heartburn and regurgitation at early follow-up. There was evidence of clinical recurrence at late follow-up (n=87) in two of 22 patients without oesophagitis before operation, two of 39 with moderate oesophagitis before operation and three of 19 patients with severe oesophagitis before operation; 92 per cent had good reflux control at late follow-up. Conclusion: Posterior partial fundoplication shows excellent reflux control at early follow-up. Ten years later fencer than 10 per cent of patients have recurrence, which is more common in patients who had severe oesophagitis before operation.