Open antireflux repairs for simple reflux esophagitis: short- and long-term results.

This analysis of the results of open antireflux surgery clearly shows a benefit for antireflux surgery in most patients who have severe esophagitis with or without hiatal hernia. The authors of this article have found many variations in the methodology used to evaluate these results. Aside from these problems, however, the authors also have noticed the remarkably serious and honest work performed by most surgeons in trying to report the truth with the methodologies available to them. The principles of antireflux surgery can be found among the different studies that are reviewed in this article. These principles include: 1. The necessity of closing the crura; 2. The importance of repositioning the distal esophagus into the abdominal cavity; 3. The necessity of increasing the LES pressure by using the musculature of the fundus; 4. The preference for using a short and floppy fundoplication to avoid side effects; and 5. The need for long-term follow-up in evaluating results.