Ten year evaluation of posterior fundoplasty in the treatment of gastroesophageal reflux: long-term and comparative study of 135 patients.

Results over a 5 to 10 year period in 135 patients with hiatal hernia treated surgically by posterior fundoplasty were compared with results in a similar group of 40 patients undergoing Nissen fundoplication. The final results demonstrate the effectiveness of both procedures to relieve gastroesophageal reflux. However, the collateral effects with posterior fundoplasty are considerably less than those with the Nissen fundoplication. The lower esophageal sphincter was longer with fundoplasty than with the Nissen procedure.

[Elemental diet and external fistulae of, the digestive system]. / Dieta elemental y fistulas externas del aparato digestivo

An elemental diet is a food which provides the basic needs in calories, proteins, vitamins and minerals with two advantages: it is predigested and leaves minimal or no residue to provide bulk. The care of 20 patients, with an elemental diet, presenting 20 external fistulas (75 per cent with low output and 25 per cent with high output) succeeded to obtain a spontaneous healing in 75 per cent of the cases, and an improvement of the general conditions of 15 per cent of the patients who were operated on because of fistula persistency. The death rate was 10 per cent. We think that the elemental diet is a useful tool in the treatment of external fistulas of patients who have preserved their bowel movements and an output smaller than 500 ml. in 24 hrs.