[Hiatal hernia. Symptoms, diagnosis and therapy].

Forty-eight patients with a mean age of 53 years were treated for hiatal hernia at the University of Würzburg Department of Surgery between 1983 and 1989. The cohort was subdivided according to type of herniation, age and sex, and symptoms. Conservative treatment sufficed in 22%, but the majority (78%) underwent surgery. Nissen's fundoplication predominated (48%); other methods used were gastropexy (17%), antrectomy with Roux's Y-gastrojejunostomy (6%) and Angelchik's prosthesis (6%). Intra- and postoperative complications included 5 splenectomies following iatrogenic trauma to the spleen, 2 cases of subphrenic abscess, and 2 with pleural effusions. The extensive discussion stresses the various operative treatment procedures and their respective advantages and drawbacks.