Chinese Journal of Modern Operative Surgery  2018, Vol. 22 Issue (2): 113-118 DOI: 10.16260/j.cnki.1009-2188.2018.02.008 |
| Clinical Research |
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| Laparoscopic Hernia Repair Combined with Nissen Fundoplication for the Treatment of Esophageal HiatalHernia: A Prospective Study |
| DING Hai-tao, HAN Zhi-jun, CAO Jie, DI Mi-la, PAERHATI·Abudureyimu
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| Department?of?General?Surgery,?Sixth?Affiliated?Hospital,?Xinjiang?Medical?University,?Urumqi?830002,?Xinjiang,?China |
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Abstract Objective To investigate the effects of laparoscopic hernia repair combined with Nissen fundoplication for the treatment of esophageal hiatus hernia. Methods A total of 157 patients with esophageal hiatal hernia treated in our hospital from January, 2016 to September, 2017 were selected as study subjects. According to the random, prospective, and collating principles, 157 patients were randomly assigned to group A (n=75) and group B (n=82). Laparoscopic hernia repair and gastric fundoplication were performed in both groups. Nissen fundoplication was administered in group A. While Toupet fundoplication was performed in Group B. The operation conditions, esophageal reflux status, and esophageal pressure were compared between the two groups. Results There was no significant difference in operative time, intraoperative blood loss, length of hospital stay, complications, and recurrence between the two groups (P>0.05). Before surgery, there was no difference in the frequency of 24-hour reflux, reflux time, frequency of long reflux, acid reflux time, lower esophageal sphincter pressure, esophageal residual pressure, esophageal relaxation rate, and ineffective swallowing within 24 hours between group A and B(P>0.05). 6 months after surgery, the results all were proved to be better than the pre-operative ones, such as the frequency of 24-hour reflux, reflux time,the frequency of long reflux, acid reflux time, and the pressure of the lower esophageal sphincter in group A and B(P<0.05). Esophageal residual pressure, esophageal relaxation rate and ineffective swallowing were significantly better than the pre-operative ones(P<0.05), and group A was significantly better than group B (P<0.05).Conclusions Laparoscopic hernia repair combined with Nissen fundoplication is superior to Toupet fundoplication in preventing anti-reflux effect, inhibiting postoperative dysphagia, and increasing the pressure of the lower esophageal sphincter.
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Published: 14 August 2018
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Corresponding Authors:
PAERHATI·Abudureyimu
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