Antireflux surgery for Barrett's esophagus: comparative results of the Nissen and Collis-Nissen operations

Using a Collis‐Nissen repair instead of a standard Nissen fundoplication to treat the reflux disease of Barrett's esophagus is controversial. This paper compares the Nissen and Collis‐Nissen operations when treating Barrett's esophagus. Thirty‐three patients with documented Barrett's esophagus (male : female, 26 : 7, median age, 48.8 years) had a Nissen fundoplication during 1976–1989. Fifty‐one patients (male : female = 41 : 10, median age = 53.2 years) underwent a Collis‐Nissen operation between 1990 and 1999. Clinical assessments, esophagogram, radionuclide emptying, manometry, 24‐h pH study, and endoscopy were obtained pre‐ and postoperatively. There was no operative death in either group. Median follow‐up was 8.0 years for the Nissen group and 6.5 years for the Collis group. Postoperative reflux symptoms were more frequent in the Nissen group (52%) when compared to the Collis group (7%, P