Clinical Application Of Laparoscopic Repair Of Esophageal Hiatal Hernia And Laparoscopic Fundoplication

Objective:To evaluate feasibility and safety of clinical application of laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication.Method: Retrospectively analyze the clinical data of 142 cases with laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication during July 2006 to August 2009 in minimally invasive surgery department of people,s of Xinjiang Uygur autonomous region. Among 142 cases, there were 62 cases with 1aparoscopic Nissen fundoplication, 80 cases with 1aparoscopic Toupet fundoplication and 45 cases combined laparoscopic surgery.Result:Operation was completely successfully in all 142 patients, only in one case esophageal injury occurred and none died. The mean operation time was 108.75±40.28 min, the mean intraoperative blood loss was 29.30±35.95 ml, the mean postoperative eating was 32.49±17.69, the mean periods of antibiotic use were 4.28±1.61d, the mean postoperative hospital stay was 6.80±3.22d. 136(95.8%) cases were followed for 4-48months (mean, 26.3months). 16 (11.2%) of patients had complications postoperatively: dysphagia in 11(7.7%) and regurgitation in 5(3.5%). At 1 month postoperatively the complication cases were 13(9.3%): dysphagia in 8(5.6%) and regurgitation in 5(3.5%). At 3 month postoperatively the complication cases were 10(7.0%): dysphagia in 2(1.4%) and regurgitation in 8(5.6%). Three months after the operation, barium and gastroscopy examination found no recurrence of the hernia in the 28(19.7%) cases.Conclusion:Comprehensive examination and perfect surgical choice may play an important role in the treatment of esophageal hiatal hernia. Laparoscopic repair of esophageal hiatal hernia and laparoscopic fundoplication is safe and feasible and minimally invasive, with good short-term results. Moreover, combined laparoscopic surgery can treat multiple abdominal disease requiring no or less additional incision, and has prodigious popularization value.