{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T04:11:13Z","timestamp":1775880673198,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2011,2,1]],"date-time":"2011-02-01T00:00:00Z","timestamp":1296518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100003761","name":"University Medical Center Utrecht Alexandre Suerman","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A positive symptom association probability (SAP) is regarded as an important selection criterion for antireflux surgery by many physicians. However, no data corroborate the relationship between symptom\u2013reflux association and outcome, nor is it clear what impact a negative SAP has on the outcome of antireflux surgery in patients with abnormal oesophageal acid exposure. This study compared long-term outcomes of Nissen fundoplication in patients with a negative versus positive SAP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Five-year outcome of Nissen fundoplication in patients with proton-pump inhibitor (PPI)-refractory reflux and pathological acid exposure was compared between those with (SAP+, 109) and without (SAP\u2212, 29 patients) a positive symptom association. Symptoms, quality of life (QoL), PPI use, endoscopic findings, manometry and acid exposure were evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At 5 years' follow-up, relief of reflux symptoms (95 versus 87 per cent), reduction in PPI use (80 to 25 per cent versus 85 to 14 per cent; P &amp;lt; 0\u00b7050) and improvement in QoL were similar in the SAP\u2212 and SAP+ groups. Reduction in acid exposure time (13\u00b74 to 1\u00b76 per cent versus 11\u00b71 to 0\u00b72 per cent of total time; P &amp;lt; 0\u00b7010), improvement in oesophagitis (44 to 6 per cent versus 61 to 13 per cent; P &amp;lt; 0\u00b7050) and increase in lower oesophageal sphincter pressure were also comparable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The subjective and objective outcomes of fundoplication in patients with pathological acid exposure are comparable among those with a positive and negative SAP. Patients with pathological acid exposure and a negative SAP can also benefit from antireflux surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7296","type":"journal-article","created":{"date-parts":[[2010,10,19]],"date-time":"2010-10-19T10:50:17Z","timestamp":1287485417000},"page":"247-254","source":"Crossref","is-referenced-by-count":29,"title":["Impact of symptom\u2013reflux association analysis on long-term outcome after Nissen fundoplication"],"prefix":"10.1093","volume":"98","author":[{"given":"J A","family":"Broeders","sequence":"first","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W A","family":"Draaisma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J","family":"Bredenoord","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gastrointestinal Research Unit of the University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J","family":"Smout","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gastrointestinal Research Unit of the University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I A","family":"Broeders","sequence":"additional","affiliation":[{"name":"Department of Surgery, Meander Medical Center , Amersfoort,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H G","family":"Gooszen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,2,1]]},"reference":[{"key":"2024093006364971300_bib1","first-page":"325","article-title":"Twenty-four-hour pH monitoring of the distal esophagus. 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