[The surgical correction of the disordered sphincteric function of the cardia].

For comparative assessment of some methods of surgical correction of the cardia the results of surgical treatment of 180 patients were analyzed. In 33 patients hiatal diaphragmatic hernia (HDH) was detected, in 84--duodenal ulcer was combined with HDH and in 63--duodenal ulcer was detected. In 15 patients operation by Hill was performed for correction of cardial function, in 9--operation by Dor was carried out, in 3--valvular gastroplication by N.N. Kanshin, in 23--esophagofundorrhaphy and in 130--modified by N. N. Kanshin and A. F. Chernousov fundoplication was performed. In 49 patients fundoplication by improved method was carried out with the use of intraoperative esophagomanometric control for adequacy of the procedure. The effectiveness of the treatment was evaluated according to the short-term and long-term results. It was thus established, that the best procedure of surgical correction of the cardia was fundoplication. Introduction of esophagomanometry during fundoplication valve formation is the most important factor contributing to adequate restoration of the cardia.