[Choice of the method of cardial correction during selective proximal vagotomy and gastric resection]

The author studied the condition of the esophagogastric junction in 376 patients with gastric and duodenal ulcer before and in the late-term periods after selective proximal vagotomy and distal resection of the stomach performed in combination with antireflux interventions on the cardia (fundoesophagorrhaphy, crurorrhaphy+fundoesophagophrenorrhaphy, fundoplication) or without such interventions. It is shown that reliable correction of the obturator mechanism of the cardia in selective proximal vagotomy may be achieved only by fundoplication. In gastric resection fundoplication is advisable in marked reflux esophagitis, distention of the hiatus esophageus of third degree, hernia of the hiatus esophageus, and cardiac ulcer. In all other patients with distal resection of the stomach crurorrhaphy+fundoesophagophrenorrhaphy is justified as a preventive measure.