Laparoscopic repair of paraesophageal hiatus hernia in infants and children: a review of 66 cases

Abstract

Objective To explore the efficacy and safety of laparoscopic repair of paraesophageal hiatus hernia in infants and children. Methods From July 2012 to August 2015, 41 boys and 25 girls underwent laparoscopic repair of paraesophageal hiatus hernias. The mean age was (26±10)(1-39) months and mean weigh (9.5±6.1)(3.2-16) kg. Upper gastrointestinal contrast radiography was performed. The clinical types were I (n=25), II (n=37), III (n=2) and recurrent hernia (n=1). And there were Toupet (270-degree) fundoplication (n=32) and Nissen fundoplication (n=34). Results All repairs were successful without recurrence or serious complications. The mean operative duration was 70 (48-230) min, the mean volume of blood loss <10 ml and the mean hospital stay of 11 days. An unrestricted diet resumed at 24-72 h The postoperative follow-up period was 1-37 months. Conclusions Both safe and feasible, laparoscopic repair of paraesophageal hiatus hernia is worthy of wider clinical applications. With greater experiences, the number of open hole may decrease from 4 to 3 holes. And its operative duration has no obvious difference with that of conventional laparotomy Key words: Hiatus hernia; Laparoscopy; Esophagus