Outcome of open antireflux surgery as assessed in a Nordic multicentre prospective clinical trial

Objective: To evaluate the outcome of antireflux surgery in various hospitals in Scandinavian countries. Design: Partly randomised controlled study, and partly open study. Setting: Hospitals throughout Norway, Sweden, Denmark and Finland. Subjects: 310 patients with chronic reflux disease and oesophagitis who were initially entered into a randomised controlled study of omeprazole and antireflux surgery. Interventions: Total fundic wrap, partial fundoplication, or omeprazole. Main outcome measures: Control of symptoms at one year. Results: 154 patients who had their symptoms of reflux completely controlled with omeprazole were initially randomised to have an open operation but 10 refused, leaving 144 for analysis. 34 patients who had only a partial response were also offered operation; 120/178 (68%) had a total fundic wrap, and 53 (30%) partial fundoplication. 6 patients had postoperative complications that required reoperation and 123 made a completely uneventful recovery. Reflux was controlled in most patients, and only 10 (6%) required further treatment with omeprazole. The outcome in those patients who only responded partially to omeprazole was similar to that in patients who had a complete response. Conclusion: The outcome of antireflux surgery throughout Norway, Sweden, Denmark, and Finland is good.