Determination of the lower esophageal sphincter pressure in patients having a Nissen or Belsey fundoplication.

Thirty patients were studied prospectively in evaluating the Nissen (28) and Belsey (2) fundoplication manometrically using the Kronsberg probe and Honeywell recorder. Twenty-eight patients in the Nissen fundoplication group had abnormally low LESP preoperatively and normal postoperative for one year with an average increase of 9 mm. Hg. They became asymptomatic and their esophageal mucosa became normal and remained normal endoscopically for three years. The only failures were two patients treated with the Belsey fundoplication. The gas bloat syndrome occurred in two patients and was relieved by esophageal dilatation. The Nissen fundoplication should be highly recommended as the surgical procedure of choice in the treatment of reflux esophagitis not responding to medical program.