October 1962

Reconstruction of the Esophageal Hiatus

Author Affiliations

From the Department of Thoracic Surgery, The Cleveland Clinic Foundation.

Arch Surg. 1962;85(4):599-607. doi:10.1001/archsurg.1962.01310040071009

Introduction  An increasing number of operations are being done for benign lesions near the esophagogastric junction. These elective procedures are performed as treatment of hiatal hernia, achalasia, and epiphrenic diverticulum. Each of these ailments presents a basic derangement in anatomy or mechanical function. Operations that have proved to be corrective for these ailments are basically simple in concept.Perhaps it is the simplicity of the procedures that explains the apparent increase in incidence of surgical failure. Postoperative hiatal hernia and reflux esophagitis with its attendant complications are all too common. The unfortunate patient who is made worse by elective operation is understandably vociferous when expressing his views toward surgeons in general or in particular. Surgeons who rely on peaceful coexistence with medical gastroenterologists know that the impact of a single failure offsets many surgical successes.It is only in the past decade that enthusiasm for the surgical treatment of hiatal

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