[Esophageal and gastric fistulas following surgery of the esophagogastric junction].

Seven cases of oesophageal and gastric fistulae after hiatal hernia surgery are reported: 4 fistulae occurred after an abdominal anti-reflux repair; 3 after an intrathoracic Nissen repair. The clinical symptomatology of these complications highly influences their therapeutical strategy. The fistulae with only an abdominal manifestation (subphrenic abscess or peritonitis) are opposed to those with mediastinal or pleural symptoms. The different modalities of treatment and their results are analysed. The authors prefer in case of a fistula with abdominal manifestation a directed fistulization associated with enteral alimentation; in case of a fistulae with thoracic manifestation an oesophageal exclusion with delayed restoration of G.I. tract continuity is indicated.