Surgical management of 100 consecutive esophageal strictures

We report our experience with 100 consecutive patients with reflux-induced esophageal structure managed surgically. Preoperative dilatation, total fundoplication gastroplasty, and postoperative dilatation were used in 98 patients. Only two required resection of the esophageal structure. We have identified preoperative factors that adversely affect the results. These include scleroderma; previous operation, either esophageal or gastric, and the severity of the esophageal stricture. Results of nonresectional operations are excellent in uncomplicated cases or with the addition of only one complicating factor. The more complicating factors, the worse the results. Those patients with three preoperative complicating factors do poorly and may benefit from esophageal resection. We conclude that results obtained from this conservative nonresectional management program justify continuance of the use of total fundoplication gastroplasty with preoperative and postoperative dilatation in the management of such patients.