Management of benign oesophageal stricture by total fundoplication gastroplasty

In the Department of Thoracic Surgery, City Hospital, Nottingham, we use total fundoplication gastroplasty routinely in the management of patients with benign peptic strictures who are unresponsive to medical treatment. This is an analysis of our results between 1983 and 1987. Fifty-six patients are included. There was no operative mortality. An overall good result was achieved in 83.9% of the patients. The results were better earlier in the disease (86.7% in grade II and 90.3% in grade I) than later (60% in grade III). We believe that conservative surgery should not be unduly delayed once medical management has failed. We now reserve resection for patients with fibrotic undilatable strictures and failures of conservative surgery.