Hiatal Hernia With Esophagitis

One hundred-sixty patients were treated surgically with a valvuloplasty technique for gastroesophageal reflux and esophagitis. All but nine patients had a sliding hiatal hernia. In no case was the hernia repaired. The surgical approach, a reefing of the sling muscles plus vagotomy, was designed to restore competence to the antireflux mechanisms of the gastroesophageal area. Ninety-two percent of the patients remain symptom-free, while 8% are occasionally symptomatic. The high incidence of associated foregut diseases suggests an embryologic factor in the development of gastroesophageal reflux.