Surgery for reflux stricture of the oesophagus

Reflux stricture of the oesophagus was surgically treated in 27 patients. Oesophageal resection and colon interposition were performed in 18 cases, and peroperative fiberoptic endoscopic dilatation with Nissen fundoplication in nine. There was one perioperative death (resection group). Postoperative complications arose in four of that group and one of the dilatation-fundoplication group. At follow-up averaging 86 months after resection and colon interposition, no patient was dysphagic; 44% experienced regurgitation, but most could avoid this by modifying living habits. Further dilatations were required by four of nine patients during follow-up averaging 30 months after dilatation-fundoplication. Fiberoptic endoscopic dilatation with fundoplication is well tolerated by fitter patients with reflux stricture of the oesophagus. In poor-risk patients the treatment should be dilatation and medical antireflux control. Due to higher complication rates oesophageal resection and colon interposition are warranted when other treatment has failed.