The combined Collis-Nissen operation for esophageal XXXX .

@entity1 @entity850 @entity1282
This report evaluates the efficacy of the combined Collis-Nissen operation in achieving long-term reflux control in @entity1 with @entity850 . A Collis-Nissen procedure with dilation of a reflux stricture was performed in 64 adults. The strictures were mild (easily dilated) in 37, moderate (requiring some force to dilate) in 17, and severe (requiring very forceful dilation) in 10. Two strictures were perforated intraoperatively. There was 1 postoperative death, and 4 @entity1 have been lost to follow-up. The remaining 59 @entity1 have been followed from 2 to 120 months (average, 43 months) after operation. Subjectively, reflux is absent in 48 (81%), mild in 4 (7%), moderate in 5 (9%), and severe in 2 (3%). Objectively, intraesophageal pH studies show good or excellent reflux control in 94% at 1 year and 66% at 2 to 5 years. @entity1282 has been eliminated in 71%, is mild in 10%, moderate (requiring occasional dilation) in 12%, and severe (requiring regular dilations) in 7%. The combined Collis-Nissen operation provides good long-term reflux control and relief of @entity1282 in most @entity1 with @entity850 . However, @entity1 with @entity850 after previous repairs are likely to have unsatisfactory results and may best be managed with resectional therapy. Resection may also ultimately prove to be a better option for @entity1 with more severe strictures.
