Laparoscopic hiatal hernia repair with composite mesh used in elderly patients: a clinical review of 35 cases

Abstract

Objective To investigate the clinical value and safety of composite mesh used in laparoscopic hiatal hernia repair in elderly patients（above 60 years of age）. Methods We retrospectively reviewed 35 elderly patients with esophageal hiatal hernia undergone laparoscopic hernia repair surgeries in Henan Provincial People's Hospital between June 2015 and June 2018. Those surgeries were completed using composite patches: 8 cases of Nissen 360-degree fundoplication, 12 cases of Toupet 270-degree fundoplication, and 15 cases of Dor anterior 180-degree partial fundoplication. Results All 35 cases of esophageal hiatal hernia repair using composite mesh were completed laparoscopically, intraoperative change to open surgery was not required. The symptoms disappeared completely in 28 cases and improved in 7 cases. 5 patients experienced various degrees of dysphagia (4 patients in the Nissen group, 1 patient in the Toupet group). 1 patient suffered abdominal distension (Dor group). All patients were followed up for 6~42 months, no recurrence occurred. Conclusions It is safe and reliable to use composite mesh for laparoscopic hiatal hernia repair surgeries in elderly patients. Toupet and Dor fundoplication has shown more advantages for elderly patients with less complication. Key words: laparoscopy; hiatal hernia; composite mesh; hernia repair; elderly patients