Comparison of Nissen total and Lind partial transabdominal fundoplication in the treatment of gastro-oesophageal reflux

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Abstract
Fifty-two patients with gastro-oesophageal reflux disease refractory to medical treatment were randomized to undergo a Nissen total (360° wrap) or Lind partial(300° wrap) transabdominal fundoplication. Each group was comparable in number (26 patients), mean age (47 and 48 years) and sex distribution (eight women). Preoperative and postoperative assessment involved a modified Visick score, 22-h intraoesophageal pH monitoring, endoscopy and manometry. Follow-up was at 6 weeks and between 3 and 33 (mean 13) months. The prevalence of heartburn and regurgitation and the results of pH monitoring improved significantly after both operations (P < 0.001). At early assessment eight previously asymptomatic patients (31 per cent) from, the Nissen group and six (23 per cent), from the Lind group experienced difficulty swallowing. Ten patients (38 per cent) in each group complained of ‘gas bloat’. Both complications had improved at late assessment in the majority of patients. No statistically significant advantage could be demonstrated, for either operation.