Mortality after operation for hiatus hernia.

When we started this investigation we were convinced that we would not be able to collect enough fatal cases to enable us to analyse the various causes of death following operation for hiatus hernia. To our surprise, inquiries made at 53 paediatric surgical centres produced a total of 67 fatalities. Most of these deaths could have been prevented if the following rules would have been followed: 1. The diagnosis must be made early and therapy must be commenced as soon as possible before there is a deterioration of the patient's general state of health increasing the risk of operation. 2. It is important to be familiar with the various operative techniques and the possible complications which they can produce. 3. Follow-up examinations are essential as certain complications will be detected by the patient himself only too late! Mortality and morbidity of hiatus hernia should be very small if the correct treatment has been carried out. Nissen's fundoplication, Rehbein's hiatal plasty and gastropexy, Lortat-Jacob/Grob's oesophagogastropexy and their modifications, all carry a low mortality and are followed by good results stopping the gastro-oesophageal reflux.