Experience of 54 cases of laparoscopic hiatal hernia repair and fundoplication

Abstract

Objective To explore the clinical efficacy of laparoscopic hiatal hernia repair in combination of fundoplication in treating patients with reflux esophagitis and hiatal hernia. Methods Retrospective analysis ofthe clinical data of 54 patients with reflux esophagitis and hiatal hernia under laparoscopic hiatal hernia repair in combination of fundoplication admitted from January 2012 to January 2016.In aspects of the operation time, intraoperative blood loss, postoperative hospitalization days and complications to evaluate the treatment effect of laparoscopic hiatal hernia repair combined fundoplication. Results There were 53(98%)patients underwent the laparoscopic hiatal hernia repair and fundoplication.One case converted tolaparotomy.47(87%)patients used mesh repair while others did not.The number of patients who did the operation of Toupet, Nissen, Dor(gastric folding degree were 270°, 360°, 180°respectively)were 32(59.3%), 19(35.2%)and 3(5.5%). Operation time was 95~355 minutes, average time(193.6±87.6)minutes.Intra-operative blood loss was 10~600 ml, average blood loss(72.5±21.3)ml; the average postoperative hospitalization stay was(8.1±7.4)days, 53 patients′postoperative hospitalization stay were 3~18 days, one was 62 days.The extubation time was 3 days after operation.The complication included: One case with digestive fistula(Nissen), who recovered in 10 days after the continuous gastrointestinal decompression and peritoneal drainage.One case had the symptom of difficulty swallowing and 2 cases(Toupet)with sickness and reflux, with conservative treatment, they recovered in 1 week.In 3 years following up, 12 patients lost access and 42 patients had complete remission. Conclusion For reflux esophagitis and hiatal hernia patients, laparoscopic hiatal hernia repair and fundoplication is a safe and effective treatment method. Key words: Hernia, hiatal; Fundoplication; Laparoscopic; Esophagitis, peptic