Post-fundoplication symptoms. Do they restrict the success of Nissen fundoplication?

The post-fundoplication symptoms were assessed in 226 patients who had symptomatical improvement of gastroesophageal reflux after Nissen fundoplication. Follow-up range was from 3 to 12 years (average 5,6 years). Of these patients, 24% were totally asymptomatic. All had transient postoperative dysphagia which improved within an average of 3-5 months. Forty four per cent had changes in habits of swallowing; 38% had increased abdominal meteorism; 31% were unable to vomit and 19% unable to belch; 12% had pain in the upper left abdominal quadrant; and 10% had dyspepsia. These symptoms were uncomfortable in 26% and disturbing in 10%. Diverse causes can be responsible for these symptoms; mechanical (narrowing of the cardia, postoperative adherences), functional (motor troubles, denervation), and depending of the patients (alimentary habits). The high frequency of post-fundoplication symptoms restrict clearly the success of Nissen fundoplication.