Long term results after Nissen fundoplication and Belsey Mark IV operation in patients with reflux oesophagitis and stricture.

This retrospective study was undertaken to compare long term results of Nissen fundoplication and the Belsey Mark IV repair in patients with reflux oesophagitis and stricture between 1972 and 1987. 105 patients were operated on for reflux oesophagitis, and 43 of the patients had stricture. There was one postoperative death (after a Belsey Mark IV repair). The cumulative recurrence rate after the Nissen operation was 9%, all recurrences of oesophagitis occurring within the first two years. The cumulative recurrence after the Belsey repair was 37%. Only 15 of 32 patients treated with Nissen fundoplication for stricture needed dilatation after operation, and then only during the first two years. "Gas-bloat" occurred in 18% of the patients treated with Nissen fundoplication. We conclude that the Nissen fundoplication is a good operation for patients with severe reflux oesophagitis and for those with peptic strictures of the oesophagus. The Belsey Mark IV repair, however, cannot be recommended for patients with strictures.