Surgical Treatment of Hiatal Hernia

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Abstract
Indications for surgical treatment of hiatal hernia are persistent symptoms after a trial of medical therapy, continued bleeding as a result of esophagitis or gastritis, stenosis of the esophagus, and incarceration of the hernia. The objectives, return of the displaced viscera to their normal position and restoration of competence of the esophagogastric junction, can be accomplished by the abdominal or the thoracic route but the approach may be dictated by other disease states that must also be corrected. In a series of 234 patients with hiatal hernia operated on by the transthoracic approach, mortality was less than 1 per cent and the recurrence rate less than 4 per cent.