Surgery for oesophageal reflux and hiatus hernia. Long-term results in 250 patients.

A series of 250 patients with oesophageal reflux and hiatus hernia were treated at North Middlesex Hospital, London, the Regional Cardiothoracic Centre, between 1968-72. These patients received surgical treatment by the "Belsey Mark IV technique" and there were no significant complications. The 7--10 year follow-up showed in 8.4% actual recurrence which was of a combined functional and anatomical nature. In 2% of the cases hernia was demonstrated only by radiology, but there was no evidence of recurrent reflux. The majority of recurrences occurred within two years of initial operation. The patients with recurrences, who underwent the second Mark IV repair, had excellent results. The improving quality of the life in the successful cases was dramatic. This series indicates that the Belsey Mark IV repair is a safe and reliable procedure and gives excellent results with relief of all symptoms.