Jejunal bypass has restored normal swallowing in six patients with benign intractable lower oesophageal stricutre resulting from (1) full-thickness reflux oesophagitis and hiatal hernia, (2) reflux associated with columnar-cell-lined oesophagus, (3) ingestion of lye, and (4) achalasia with retort-shaped oesophagus. In this technique a segment of jejunum is joined to oesophagus and stomach without resection of the stricture. The procedure is of greatest value in elderly patients with persistent dysphagia and poor respiratory reserve and when previous surgical procedures have failed to relieve the obstruction caused by a benign stricture. Though the number of such patients is small their needs are great and this procedure has provided excellent relief of symptoms during a follow-up period ranging from three to nine years.
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