AN EXPERIMENT OF MODIFIED COLLIS-NISSEN PROCEDURE FOR A CASE OF ESOPHAGEAL STENOSIS DUE TO GASTROESOPHAGEAL REFLUX DISEASE

A 62-year-old man who had been administered proton pump inhibitor for gastroesophageal reflux disease (GERD) was admitted to the hospital because of heart burn with dysphasia constricts. On admission, he could take only liquid diet and sometimes complained of nausea and vomiting. The middle part of the esophagus was severely stenotic and the upper esopiagus was specially ballooning. The fiber scope couldnot pass through the stenotic region into the stomach. The results of 24 hours pH monitoring in the esophagus were: (1) there were 9 times of acid reflux for longer than 5 minutes (pH below 4.0); (2) incidence of pH below 4.0 was 26.3%; and pH above 7.0 amounted to 31.1%. We treated this patient with modified Collis-Nissen procedure and thn evaluated the expandable metaric stent (EMS) into the esophageal stenotic portion. The postoperative course was uneventful. The patient could take common diet and the incidence of pH below 4.0 decreas 0.9%. Sometimes, GERD induces esophageal stenosis regardless of medication of proton pump inhibitor or H2 receptor antagonists. So we should keep surgical tratment in mind before occurrence of the esophageal stenosis.