Long-term follow-up for treatment of complicated chronic XXXX .

@entity1 @entity2910 @entity357 @entity1282 @entity354
In the past 18 years the Nissen fundoplication has undergone a few modifications and changes in our institution and all over the world. The aim of this study is to review the long-term (up to 20 years) results of Nissen fundoplication in 350 @entity1 and to evaluate the effect of major modifications in the technique of fundoplication in these @entity1 . Three hundred fifty @entity1 with symptomatic chronic @entity354 have been treated with Nissen fundoplication in our institution since 1966. They were divided into four groups: @entity1 who had a long, tight fundoplication; @entity1 who had a short, floppy fundoplication; @entity1 with crural approximation; and @entity1 without crural approximation. The preoperative and postoperative findings of these @entity1 were evaluated in each group. Group 1 had more immediate and long-term @entity1282 compared with group 2. Also, "gas bloat" syndrome was more prevalent in group 1 than group 2. The location of Nissen fundoplication (chest or abdomen) or the addition of @entity357 repair did not change the outcome. In @entity1 with intact Nissen fundoplications, their @entity2910 healed, and their symptoms disappeared. The rate of recurrence of symptoms was 5%. Recurrence of symptoms was associated with disruption of the fundoplication, which usually happened within the first two years after operation.
