Results of fundic patch operation for severe stricture of the esophagus

Eighteen patients ranging in age from 32-82 years with benign distal esophageal stricture underwent and survived fundic patch operation. Twelve of these patients had undergone esophageal dilatation but without success. Five had had surgery for hiatal hernia using Hill, Belsey or Lortat-Jacob techniques. Middle laparotomy was done in five and left thoracotomy in thirteen. A fundic patch with a 270 degrees fundoplication was performed in seven and a fundic patch with 360 degrees fundoplication in the remaining eleven. The average hospital stay was 12.3 days. Dysphagia disappeared in seventeen and persisted for eight months in one patient. Three patients required instrumental dilatation for a few months. Endoscopic examination, pH study and X-ray fluoroscopy were done. Gastroesophageal reflux was nil in patients treated with Nissen's 360 degrees fundoplication and three of these 7 patients without Nissen's fundoplication had gastroesophageal reflux. Epithelialization of the patched esophageal wound was evident 6 months after the operation.