[Surgical treatment of gastroesophageal reflux by modified Hill's posterior cardiopexy. Apropos of 441 cases].
Between 1972 and 1986, 490 modified Hill's procedures were performed for gastro-esophageal reflux; 441 cases were retrospectively studied consisting of 245 males and 196 females, aged from 4 days to 83 years, with a mean age of 41 years. Average duration of gastrointestinal symptoms was 5.4 years. The proposed technique is described, allowing cardiopexy without intraoperative manometry. Mortality was 1.4% (6 cases); one death was due to surgery. Morbidity was 5.4% (24 cases). With a mean follow-up of 5.2 years, a clinical cure was obtained in 93.5% of cases. Causes of failures were analyzed: the only possible pre-operative factor was the presence of peptic stenosis. Pylorospasm appeared to be a post-operative cause of failure. The 28 patients for whom surgery failed were medically treated (18), dilated (5) or reoperated (5). Three new cardiopexies and 2 fundoplications cured the last 5 patients with a mean follow-up of 5.8 years. Recurrences of symptoms and discoveries of failure were generally detected early after the operation: 20 before 6 months (71%), 1 between 6 months and 1 year, 2 between 1 and 2 years, 3 between 3 and 4 years, 1 between 4 and 5 years.
Ribet
M
M
Clinique Chirurgicale Ouest, CHU, Lille.
Mensier
E
E
Pruvot
F R
FR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D013536:Suture Techniques
Traitement chirurgical du reflux gastro-oesophagien par cardiopexie postérieure de Hill modifiée. A propos de 441 cas.