Hiatus Hernia With and Without Esophageal Stricture: Experience with the Belsey Mark IV Repair

Abstract

The aims of surgical treatment for hiatus hernia are elimination of gastroesophageal reflux and relief of symptoms. Sixty-one consecutive adult patients who underwent hernia repair by the Belsey Mark IV technique have been reviewed symptomatically and roentgenographically. Judged by strict roentgenographic criteria, 2 patient groups were identified. Hernia repair gave good results in 34 of the 43 patients without severe periesophagitis and esophageal shortening. Symptoms were relieved in 39 of this group. However, in 17 patients with severe transmural and periesophageal disease, only 4 had a good roentgenographic result, although 9 had symptom relief. Eleven patients in the overall series had an esophageal stricture. Prevention of reflux in these patients has been shown to result in stricture resolution.