The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 518-524, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Management of acid-peptic esophageal strictures
LH Toledo-Pereyra, H Michel, G Manifacio and EW Humphrey
Eighty-nine patients with benign acid-peptic strictures of the esophagus
were evaluated. Of these, 56 patients were treated by dilatation and
medical therapy, whereas 33 underwent operative therapy because medical
therapy failed. Three patients, all psychotic and having post-emetic
strictures, required resection of the stricture and a colon interposition.
Twenty-nine patients underwent a Belsey or Nissen fundoplication combined
with esophageal dilatation. Fourteen of 29 had an associated vagotomy and
15 did not. Two patients of this 29 had a poor result, one of whom had a
post-emetic stricture. Although the patients having a concurrent vagotomy
and pyloroplasty had the more severe disease,there was no significant
difference between the results in the two groups. It is concluded that most
patients with such esophageal strictures may be adequately treated without
resecting the stricture and that the routine addition of a vagotomy and
drainage procedure is probably not indicated.
