[Surgical treatment of esophageal reflux disease associated with a short esophagus]

Supradiaphragmatic fundoplication is effective therapy of complicated GER with a feasible morbidity and low mortality. These favourable results moreover do not apply to patients with primary oesophagitis but to a small percentage of patients suffering either from severe transmural oesophagitis or previous unsuccessful fundoplication. Under these conditions surgery is difficult regardless of the selected technique. An alternative possibility of supradiaphragmatic fundoplication in short oesophagus is Collis gastroplasty and fundoplication. The authors recorded good results of this operation/4, 12/. It may be, however, assumed that, at least in patients after previous fundoplication, mobilization of the oral portion of the stomach is associated either a further alteration of its blood supply and thus the risk of ischaemia of the "neo-oesophageal" suture. Supradiaphragmatic fundoplication is thus in the author's opinion the most effective therapeutic method in oesophagitis, performed on account of gastroesophageal reflux in short oesophagus.