Surgical management of benign stricture from reflux oesophagitis

L. Bonavina, A. Segalin, U. Fumagalli, A. Peracchia

Research output: Contribution to journalArticle

Abstract

From January 1976 to December 1994, out of 605 patients with reflux oesophagitis, 166 (27.4%) presented with an oesophageal stricture, and 68 of these (40.9%) underwent surgical therapy. Thirteen of the 68 patients (19.1%) had an associated Barrett's oesophagus. Oesophageal manometry revealed scleroderma in nine individuals (13.2%). The stricture was undilatable in 11 patients (16.1%) observed before 1985. An oesophageal-sparing operation was performed in the majority of patients: fundoplication (n = 39), Collis gastroplasty plus fundoplication (n = 10), and total duodenal diversion (n = 4). Oesophageal resection was performed in 15 patients (22%); 12 of these individuals were operated on before 1985. The mortality rate was 4.4%: two patients died of necrosis of the interposed colon and one of acute pancreatitis. The average follow-up time was 27 months (8-136). Oesophageal-sparing procedures significantly reduced the need for further endoscopic dilatation (P <0.001). Standard fundoplication was successful in 30 out of 39 patients (77%). Reasons for a failed fundoplication were a long, hard stricture, an ineffective partial wrap in patients with unrecognized short oesophagus, or underlying scleroderma. Regression of Barrett's mucosa was not recorded with any of the conservative surgical procedures.

Original languageEnglish
Pages (from-to)175-178
Number of pages4
JournalAnnales Chirurgiae et Gynaecologiae
Volume84
Issue number2
Publication statusPublished - 1995

    Fingerprint

Keywords

  • Barrett's oesophagus
  • oesophagus
  • reflux oesophagitis
  • stricture

ASJC Scopus subject areas

  • Surgery

Cite this