[Hiatal hernia--reflux disease. Indications for surgery and initial results of a new treatment method]

Indications for the operative treatment of hiatus hernia with reflux oesophagitis are grade III and IV reflux oesophagitis; if the total acid period equals or exceeds 1.3% of the time of the period of time during which the patient was in supine position (pH-examination); if acid clearance lasts 2.86 min or more after a single reflux period; if radioisotopic counts over the sternal region exceed 3.5--4% of those obtained over the stomach area. Since 1977 we performed a new anti-reflux-operation, which we call "Teres-plasty"in 42 patients with axial hiatus hernia. The procedure is a modified gastropexy by using the ligamentum teres. First results seem to prove that this method can avoid reflux without postoperative syndromes as gas bloat syndrome and dysphagia, which are known to occur after fundoplication.