[The high pressure zone at the esophagogastric junction after 180 degree anterior fundoplication].

Twenty-nine patients in whom 180 degrees fundoplication was performed were studied manometrically before and 6-12 months and 6-13 years (mean 9.5 years) after operation. The resting pressure of the HPZ was 6.44 +/- 4.74 mmHg before operation, 12.72 +/- 6.17 mmHg at 6-12 months and 11.37 +/- 4.55 6-13 years later. The postoperative increase was significant in both early and late measurements. The slight decrease observed in late examinations was not significant. The length of the HPZ was not modified by surgery. However, the length below the point of respiratory inversion increased significantly from 1.06 +/- 1.04 cm before operation to 2.65 +/- 0.85 postoperatively and 2.24 +/- 0.68 in long term measurements. These changes occurred in the majority of patients but were unrelated to the clinical situation. Sixty-one patients who had manometry after 6-12 months were controlled clinically during 9.5 years. In 7 patients there was a symptomatic recurrence. Manometric values were similar to those found in assymptomatic patients. Anterior fundoplication (180 degrees) increases the tone and the length of the HPZ below the respiratory inversion point. On the other hand, the manometric changes observed do not have individual prognostic value.