Hiatus hernia: a comparison between two methods of fundoplication by evaluation of the long-term results

This paper presents a comparative study of two methods of fundoplication, a Belsey-like procedure and a Nissen-Rossetti operation in the management of 283 cases of hiatal hernia from 1962 to 1974. The methods, history, and preoperative findings are described, and the mortality and morbidity rates, particularly related to recurrence, are discussed. A short historical review is included in the discussion, which also deals with the anatomic and physiologic factors thought to be involved in the maintenance of the competence of the cardia. The author's reasons for preferring a Nissen operation are outlined. The management of peptic stricture and of shortening due to periesophagitis by modification of this technique is described.