Fascia lata graft repair of esophageal hiatal hernia

Abstract

Two hundred eighty-nine patients have been operated upon for hiatus hernia in the last ten years. A repair procedure has been developed in which a fascia lata graft is sutured to the under surface of the diaphragm. The approach is through a left thoracotomy incision and a circumferential incision in the diaphragm. The reason for adopting this technic are set out. One hundred patients have been followed up between three and six years after operation, and eight-nine have undergone a full and detailed evaluation. The results are described with emphasis on detailed facts rather than clinical qualitative impressions. Although the over-all recurrence rate is low (5 per cent), dissatisfaction is felt at the high incidence of postoperative dysphagia which, although mild in all but three patients, is undoubtedly due in the majority to failure to leave an adequate hiatus for the passage of a normal bolus.