[Surgery in para-esophageal hiatal hernia: technic and results]

40 patients with paraesophageal hiatus hernia have undergone surgery over a period 25 years' period. Surgery consisted of gastropexy in 38 patients (ventral corpopexy in 32, fundophrenicopexy in 19), narrowing of the hiatus in 24 and fundoplication in 14. There was one operative death (2.5%). On follow-up 3 to 24 years later (mean 12.5 years) 17 of 20 patients (85%) have good or excellent results. 2 patients without additional antireflux surgery had to be reoperated later because of severe reflux disease (secondary fundoplication). 1 patient with gastropexy and fundoplication has recurrent reflux disease. X-ray studies in 18 patients showed recurrent paraesophageal hiatus hernia in 9 (50%). After operation for paraesophageal hiatus hernia a good clinical long-term result can be expected. To reduce the frequency of recurrent hernia, technical modifications should be considered.