[Surgical procedure in joint cardiospasm and cardial hiatal hernia]

In 39 patients cardiospasm was associated with a hiatal hernia or the latter was formed in the process of treatment by cardiodilatation. An analysis of results of the treatment has shown that pneumocardiodilatation under control of esophagomanometry should be considered the method of choice in the treatment of such patients. The decreased gradient of the gastroesophageal pressure up to 12-14 mm of mercury is responsible for prevention of reflux-esophagitis. Operative treatment is indicated when cardiodilatation is ineffective or the manometric control is impossible. Cardiomyotomy in combination with an "incomplete" fundoplication is preferable. There are no good reasons for performing fundoplication after Nissen in patients with cardiospasm.