[Surgical treatment of gastroesophageal reflux. Evaluated by manometry and 24-hour pH monitoring of the esophagus].

From 1980 to 1989, 46 patients underwent surgery for pathological gastro-oesophageal reflux disease; 28 with Nissen technique, nine with Hill technique and nine with a modified Belsey technique. 11 patients (24%) experienced postoperative complications, 21% after Nissen, 33% after Hill and 22% after Belsey. Two of six patients suffered recurrence of their reflux symptoms after Belsey, three of six after Hill and two of 26 (8%) after Nissen. 85% experienced no reflux symptoms after Nissen fundoplication. 17 patients suffered from flatulence, three were not able to belch and two were not able to vomit. Median lower oesophageal sphincter pressure before Nissen fundoplication was 6.0 mmHg and length was 2.0 cm. After the operation the pressure increased to 10.0 mmHg and the length to 3.0 cm. Four patients underwent ambulatory 24-h oesophageal pH monitoring both preoperatively and postoperatively. The preoperative registration was pathological in all patients, but in three patients the postoperative pH was normal.