Reflux control following gastroplasty.

A Belsey gastroplasty was performed on 135 patients, 132 of whom were available for follow-up. Despite a low incidence (1.5%) of anatomical recurrence, the operation failed to control reflux effectively, and the incidence of continued reflux is 44.6%. Because of this failure to control reflux, a Nissen fundoplication has been added to the gastroplasty tube. In a group of 78 patients, radiological recurrence has occurred in 1 patient, with no patient experiencing symptoms of reflux. Manometric comparison between the Belsey and Nissen gastroplasty shows more effective tone elevation of the high pressure zone and a more effective decrease in disordered motor activity of the lower esophagus.