Surgical Repair of Sliding Esophageal Hiatal Hernia

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Abstract
THE SURGICAL management of sliding esophageal hiatal hernia is currently under review in many institutions, as evidenced by the number and variety of operative procedures which have been proposed. Although most reports indicate that the majority of patients experience symptomatic improvement after operation, rates of recurrence, based on roentgenographic evidence, vary from 1 to 48%.1-3 Seldom, however, has the relationship of recurrence to symptomatic results been discussed, nor have the criteria for the diagnosis of a recurrent hernia been clearly stated. Furthermore, it has been suggested that simple operative reduction of the hernia may fail to control symptoms if esophagitis is present and that procedures designed to control gastric acidity are also desirable.4,5 In an effort to clarify these discrepancies and uncertainties, the present long-term follow-up study of patients who had operative repair of an uncomplicated sliding esophageal hiatal hernia at the Mayo Clinic was undertaken. Materials and

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