Gastroplasty combined with partial fundoplication.

Gastroplasty, as proposed by Collis, combined with fundoplication of varying degree, has been increasingly used during recent years for management of hiatal hernia complicated by shortened oesophagus and oesophageal stricture. A modification of this procedure using 180 degree fundoplication and the transthoracic-transdiaphragmatic approach is described. Thirty consecutive patients have been subjected to the procedure since 1973. The clinical results and results of X-ray examinations and laboratory investigations of gastro-oesophageal reflux in 29 patients examined postoperatively are analysed. The concept of combining artificial lengthening of the oesophagus with fundoplication is considered to be a promising approach for solving the problems associated with the management of hiatal hernia complicated by shortened oesophagus.