Nissen vs. Collis-Nissen

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kefalo
Regular Member


Date Joined Mar 2011
Total Posts : 26
   Posted 3/8/2011 4:48 AM (GMT -6)   
I am having problems understanding whether Collis-Nissen is done only in specific cases (such as shortened esophagus) or does the patient has an option to choose between the two.

And if it's the former what constitutes a shortened esophagus? Is the mere presence of hiatus hernia also a shortened esophagus?

Anyway, I have read a study saying that success rates, post-op side effects and chances of procedure failure lowered by Collis-Nissen.

5 year success rates were 83% in Nissen versus 100% in Collis-Nissen and a 10 year success rate was 63% vs. 90%.

Anybody here who can clarify this for me and the rest of us?

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 3/8/2011 8:42 AM (GMT -6)   
 
The way I understand it, Collis-Nissen is done only in specific cases (such as shortened esophagus).
 
This would be a good discussion to have with your Dr. as well as getting a second opinion.
 
Good Luck,
 
Kitt

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kefalo
Regular Member


Date Joined Mar 2011
Total Posts : 26
   Posted 3/8/2011 11:11 AM (GMT -6)   
Thanks, Kitt. I don't think my current doctor is a candidate for that sort of a conversation since the only way he wants to talk about surgery is when he's telling me to stop thinking about it. I would like to see him last in my body for one day. Just one day.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 3489
   Posted 3/8/2011 5:26 PM (GMT -6)   
Welcome Kefalo -
Kit is right.  The Collis gastroplasty, in which  part of the stomach is stapled into a tube to make a longer esophagus, is only for unusual cases.  
 
The best thoracic surgeons go up into the mediastinum and cut loose the attachments to the esophagus to get it to hang down low enough, past the diaphragm and into the abdomen.  The information you have been reading may be old.  There's an awful lot of outdated info on the 'net.  Experienced, top surgeons should have at least 94% positive results even with old people with Nissen these days.
 
Here's a long article by some very good surgeons that clearly explains, with pictures and graphics, the different procedures:
http://www.nature.com/gimo/contents/pt1/full/gimo56.html
It's not super-current, but the procedures are still in practice.  It's worth a bookmark!
 
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