[Current aspects of the diagnosis and surgical treatment of reflux esophagitis]

For a period of 18 months (1986-1987) a total of 2595 fiber gastroscopies have been performed for different reasons. Reflux esophagitis (RE) was visualized in 436 of the patients undergone fiber gastroscopy (16.8 per cent), histologically verified in 64. The esophageal lesions in 11 patients were severe--III I and degree, according to the endoscopic classification of Plüoke, 1 of them having ulcer and 2 stricture of the esophagus. All 11 patients were operated. Nine had fundoplasty performed by Nissen's technique, associated in 5 with proximal selective vagotomy and in 1 with gastric resection for simultaneous occurrence of RE and duodenal ulcer. Resection of esophagus with esophagogastric anastomosis was performed in the two patients with esophageal stricture. On control examination after 3 and 6 months 5 of the patients having undergone fundoplasty reported mild dysphagia. Control fiber gastroscopy with biopsy showed significant decrease, even complete disappearance of the esophageal lesions and healing of the duodenal ulcer. One patient who had esophageal resection suffered restenosis, prompting bougienage with satisfactory result. Problems related to the diagnosis, indications for operation and operative tactics in severe forms of RE are discussed.