{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T17:43:43Z","timestamp":1761155023465},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[1984,3,1]],"date-time":"1984-03-01T00:00:00Z","timestamp":446947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1984,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>It is not widely recognized that duodenal contents are implicated in the causation of severe reflux oesophagitis and stricture formation in patients with hiatus hernia. In a randomized prospective trial, including only patients with severe oesophageal changes, standard Nissen fundoplication has been compared with antrectomy and Roux-en-Y reconstruction. Twenty-two patients were randomized to each group. The 42 surviving trial patients have been followed for an average period of over 5 years. Good results (Visick I or II) have been achieved in 91 per cent of 22 patients having antrectomy and Roux-en-Y anastomosis (Group B), compared with 65 per cent of 20 patients surviving after Nissen fundoplication (Group A). Poor results (Visick III or IV) seen in seven patients (35 per cent) in group A were almost all associated with failure of fundoplication to stop reflux. Two of these patients have subsequently had antrectomy and Roux-en-Y reconstruction with excellent results. Antrectomy with Roux-en-Y gastrojejunostomy appears to be superior to a standard anti-reflux procedure as primary surgical treatment in these patients. The technique is recommended; (1) where the patient has a fixed irreducible hiatus hernia; (2) where previous surgery at the hiatus has failed and rendered reoperation hazardous.<\/jats:p>","DOI":"10.1002\/bjs.1800710303","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T00:39:18Z","timestamp":1172882358000},"page":"181-184","source":"Crossref","is-referenced-by-count":46,"title":["Randomized prospective trial of Roux-en-Y duodenal diversion <i>versus<\/i> fundoplication for severe reflux oesophagitis"],"prefix":"10.1093","volume":"71","author":[{"given":"G F","family":"Washer","sequence":"first","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M W L","family":"Gear","sequence":"additional","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B L","family":"Dowling","sequence":"additional","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E W","family":"Gillison","sequence":"additional","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C M S","family":"Royston","sequence":"additional","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Spencer","sequence":"additional","affiliation":[{"name":"Gloucestershire Royal Hospital, Northampton and Kidderminster General Hospitals, Hull Royal Infirmary and The Royal Postgraduate Medical School , Hammersmith,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1984,3,1]]},"reference":[{"key":"2024092716212012200_bib1","first-page":"149","article-title":"Hiatal hernia complicated by oesophageal stricture","volume":"145","author":"Gatzinsky","year":"1979","journal-title":"Acta Chir Scand"},{"key":"2024092716212012200_bib2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/bjs.1800660402","article-title":"Conservative surgery in reflux stricture of the oesophagus associated with hiatal hernia","volume":"66","author":"Moghissi","year":"1979","journal-title":"Br J Surg"},{"key":"2024092716212012200_bib3","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1002\/bjs.1800620607","article-title":"The management of peptic oesophageal stricture","volume":"62","author":"Williamson","year":"1975","journal-title":"Br J Surg"},{"key":"2024092716212012200_bib4","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/archsurg.1979.01370280190032","article-title":"Effective surgical therapy of esophagitis. 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