Purpose: To evaluate the usefulness and diagnostic accuracy of the radiologic examination of the oesophagus and stomach in the follow-up of patients who had an anti-reflux procedure with the purpose of identifying the normal radiographic pattern, possible surgical complications and the causes of failure of the surgical treatment.
Material and methods: From February 1999 to September 2000, we radiographically reviewed 11 patients (5 men and 6 women) age range 17-69, mean age 49, who had a surgical procedure of fundoplication for hiatal hernia and/or gastroesophageal reflux (7 Nissen procedures, 2 Belsey-Mark IV, 1 Toupet, 1Dor). Four surgical procedures were laparoscopic, seven were open. All patients were reviewed with single contrast (barium sulphate 60% weight/volume) and/or double contrast technique (effervescent powders + barium sulphate 250% weight/volume) and with the acquisition of radiographs in upright, supine, prone, oblique and lateral positions.
Results: 5 of the patients who had a fundoplication procedure suffered complications. In one patient the fundoplication was tight; in two patients the fundoplication had broken and migrated in the thorax; in one the fundoplication had loosened; in one patient it had looseed and migrated in the thorax. In the remaining 6 cases, the passage of the barium column through the fundoplication was normal, as well as the intra-abdominal position of the fundoplication.
Conclusions: The possibility to perform laparoscopic fundoplication procedure has increased the number of patients selected for surgical treatment. Successful relief of gastroesophageal reflux symptoms can be achieved in 90% of patients treated with antireflux fundoplication. Less than 10% of cases may have complications, with recurrence of gastroesophageal reflux manifestations. The radiographic examination of the esophagus and stomach still represents an effective diagnostic test in the follow-up of these patients.