Introduction.

It has been established in the literature that a proportion of patients who undergo antireflux surgery present shorthening of the esophagus. If this is not recognized, it may be associated with anatomical failure of the surgery and symptomatic recurrence. The incidence of this condition is unknown in our environment.

Methods.

Retrospective, descriptive study in patients with hiatal hernia (HH) and gastroesophageal reflux disease (GERD) undergoing laparoscopic antireflux surgery in a high complexity institution over a three-year period. Demographic, clinical, operative, and postoperative characteristics were described. Cases of short esophagus and the surgical technique used to correct it were identified.

Results.

One hundred and ten laparoscopic antireflux procedures were performed, of which 56 (50.9%) were HH repair plus fundoplication and 54 (49.1%) were giant HH repair plus fundoplication and/or decompressive gastrostomy. Seven (6.3%) patients had a short esophagus and required esophageal lengthening by Collis-type gastroplasty. At preoperative evaluation, five (71%) reported sympotms lasting more than 4 years, five (71%) had dysphagia, six (85.7%) had giant HH, and six (85.7%) had some degree of esophagitis. The average hospital stay was 4.4 days. There was one major complication and no mortality. All achieved adequate postoperative radiological and symptomatic control.

Conclusions.

Short esophagus is a real condition, which should be anticipated especially in patients with giant HH and chronic GERD. Laparoscopic Collis esophagogastroplasty is a reasonable treatment alternative.

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