Current Approaches to Correction and Evaluation of Results

Current controversy regarding the choice of operation for the hiatal hernia-reflux complex stems from incomplete understanding of the pathophysiology of reflux and esophagitis, from disagreement about the mechanisms responsible for success or failure of operative repair, and from a lack of uniform methods and objectivity in reporting results. Operations which are almost uniformly successful in preventing reflux have recently become available. The purpose of this paper is to record our experience with the Belsey and Nissen operations, to correlate the pre- and postoperative condition with esophageal manometry, and to describe a method for introducing objectivity into the reporting of results.