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Hiatal hernia with severe reflux esophagitis: treatment by superselective vagotomy and Nissen fundoplication
Abstract:
Thirty-two patients had surgical treatment for severe reflux esophagitis due to sliding hiatal hernia. A superselective vagotomy was done as an adjunct to a Nissen fundoplication as the antireflux procedure. All patients had severe esophagitis; 16 patients (53%) had dysphagia, nine patients (28%) had esophageal stricture, and all had failed an intensive trial of medical treatment with antireflux measures, antacids, and histamine receptor blockers. Follow-up averaged 14.3 months (3 to 38). Three patients (9%) had significant postoperative esophagitis. The other 29 patients, including those with esophageal stricture, are now asymptomatic. We conclude that the combination of a superselective vagotomy and a Nissen fundoplication is a safe and effective operation for the treatment of severe reflux esophagitis.
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