Surgical treatment of esophageal stricture in patients with scleroderma

Two patients with dense distal esophageal strictures associated with progressive systemic sclerosis (scleroderma) are discussed. Both were treated with a Thal-Nissen procedure. Both patients now can eat without difficulty and have experienced no dysphagia. Although the peristalsis in the esophagus is markedly depressed or absent, food still can pass through the Nissen wrap into the stomach. The Thal-Nissen patch and fundoplication is an effective and well-tolerated operative procedure for the unusual patient with distal esophageal stricture and scleroderma.