[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].

During the years from 1948-90, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated on up to the year 1988 were followed up over a long period. Preoperatively gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatoraphy, fundoplicatio, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.