[Physiologic surgery for anomalies of the cardio-hiatal region].

In 11 years (1971-1981) 1.040 cases of anomalies of the cardio-hiatal sector have been controlled in the Children's Hospital of the Social Security of Barcelona, 101 patients were operated. Surgical indication was based on the following facts: size of the hernia, poor clinical evolution with postural treatment, or infants of more than 2 years who also presented a high gastric acidity or a clearly pathological pHmetry, or, lastly, a social cause. We have used a much more physiological technique than that of Nissen, based on the obtention of a large segment of the abdominal esophagus on which changes of pressure existing in the abdominal and thoracic cavities can act, clearly registered in manometric studies effected before and after operation. The few complications observed in this large series of operated children speak clearly in favour of its necessary diffusion and utilization.