A clinical comparison between the operating methods of Laparoscopic Toupet and Dor fundoplication for treating the hiatal hernia combined with gastroesophageal reflux disease

Abstract

Objective To comparison the advantages and disadvantages of laparoscopic Toupet and Dor fundoplication in the treatment of hiatal hernia combined with gastroesophageal reflux disease. Methods Statistics Analysis 127 patients of GERD in our hospital from December 2014 to January 2017, 41 underwent laparoscopic laparoscopic Toupet fundoplication(Toupet Group).86patients underwent laparoscopic laparoscopic Dor fundoplication(Dor Group). Comparing the GerdQ rating scale scores, intraoperative and postoperative recovery and so on the between patients with esophageal reflux conditions, esophageal manometry in three groups. Results Two groups of patients were improved significantly compared with preoperative in reflux conditions(P 0.05). We followed up these patients for 6~18 months(median 12 months). 6~18 months(median 12 months). There was no significant difference in recurrence[Toupet group: 1case(2.44%), Dor group: 1case(1.12%), χ2=0.292, P=0.589]. There was no significant difference in postoperative complications(χ2=4.362, P=0.359). Conclusion It was safe and feasible for this two fundoplications treating HH combined with GERD.But laparoscopicDor fundoplication was better than Toupet fundoplication in reducing the number of reflux episodes and suppressed the long-reflux and increase LES pressure(mean resting respiration)and the incidence of postoperative dysphagia. Key words: Fundoplication; Esophageal foramnia; Gastroesophageal Reflux Disease