Objective: To explore the anti-reflux effects of esophagogastric anastomoses by reverse stapling with Nissen fundoplication (RSNF).
Methods: A total of 103 cases of lower esophageal carcinomas and esophagogastric junction carcinomas undergone reverse stapled anastomoses with Nissen fundoplication between July 2009 and December 2010 at our hospital were retrospectively reviewed. And fistula, stricture and gastroesophageal reflux were compared with those of 130 traditional cases.
Results: RSNF required more time than the traditional group (16.42 vs 14.02 min, P < 0.001). No fistula was found in neither group. There were 13 complications in RSNF and 23 in the traditional group (χ(2) = 0.44, P = 0.58). The rate of stricture was 4.8% (5/103) in RSNF and 6.9% (9/130) in the traditional group (χ(2) = 0.44, P = 0.58). There were 16 reflux esophagitis (15.5%) in RSNF and 29 in the traditional group (22.3%) (χ(2) = 2.57, P = 0.46). The post-RSNF reflux symptoms were more severe than the traditional group (31.1% vs 49.2%, χ(2) = 7.825, P = 0.007, score of GerdQ>8).
Conclusion: Reverse stapling with Nissen fundoplication may be conveniently performed with definite anti-reflux effects for esophagogastric anastomoses.