[Surgical treatment of hiatal hernia in adults. Indications, technical and tactical considerations on 310 operated cases].

On the basis of 310 cases of hiatal hernia surgically treated, the anatomical, pathophysiological and clinical aspects are reviewed together with their surgical consequences. In rolling type hernia, gastroesophageal reflux and its sequelae do not occur: the treatment is based only on reduction and suture of the fundus to the undersurface of the diaphragm with repair of right crus. In sliding hiatal hernia the purpose of operation is functional one, that is satisfactory and lasting control of gastro-esophageal reflux. With one exception, the fundamental step of all successful procedures of repair is the creation of restoration of an infradiaphragmatic segment of esophagus: it puts the lower esophageal sphincter into the abdominal cavity with restoration of gastroesophageal competence.