Hiatus hernia repair combined with the construction of an anti-reflux valve in the stomach.

An operation is described that combines hiatus hernia repair with the construction of an anti-reflux valve in the stomach immediately beyond the cardia. One hundred and ten patients treated by this operation, including 28 with panmural oesophagitis, have been followed up by clinical and radiographic assessment at yearly intervals for periods from a little over 1 year to over 5 years. Three patients had return of reflux symptoms, 2 of these being the only patients in the series with X-ray reflux at follow-up. The return of reflux in these patients appeared to result from anatomical changes that were probably caused, at least in part, by over-tight application of the stapling instrument used in the operation.