Curative effect and prognosis of laparoscopic patch repair of esophageal hiatal hernia_West China Medical Journal

Authors：

FAN Jiajun ,  TAO Qingsong , DING Yuan , HU Yingjie , XU Yifan , HU Yang , JIANG Zhengjie

Department of General Surgery, Zhongda Hospital Southeast University, Nanjing, Jiangsu 210009, P. R. China;

Corresponding author：

TAO Qingsong, Email: taoqs_nju@126.com

Keywords：

Laparoscopic surgery; Hiatal hernia; Gastroesophageal reflux disease; Fundoplication; Mesh

DOI：

10.7507/1002-0179.201910119

Video：

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Objective To analyze the effect and prognosis of laparoscopic patch repair of esophageal hiatal hernia.Methods From October 2014 to January 2019, 100 patients with gastroesophageal reflux disease undergoing laparoscopic esophageal hiatus hernia repair were randomly divided into the patch group and the non-patch group. All patients underwent laparoscopic repair of esophageal hiatal hernia plus fundoplication (Nissen’s method). On that basis, the patients in the patch group used special mesh for esophageal hiatal hernia repair, while the ones in the non-patch group did not. All the patients were followed up for a long time. The operative effect, postoperative complication rate, recurrence rate, and satisfaction rate of the patients between the two groups were compared.Results A total of 98 patients were successfully followed up for more than one year, including 68 in the patch group and 30 in the non-patch group. One year after surgery, the differences between the patch group and the non-patch group in the improvements of reflux attack, heartburn, dysphagia, and food intake were statistically significant (P<0.05); there was no significant difference between the patch group and the non-patch group in satisfaction rate (82.4% vs. 73.3%, P>0.05); the differences in recurrence rate (2.9% vs. 26.7%) and incidence of dysphagia (47.0% vs. 6.7%) between the patch group and the non-patch group were statistically significant (P<0.05).Conclusion For the patients with gastroesophageal reflux disease caused by esophageal hiatal hernia, the laparoscopic repair of esophageal hiatal hernia + Nissen fundoplication on the basis of reasonable selection of special mesh for esophageal hiatal hernia can obtain satisfactory clinical effect.

Citation： FAN Jiajun, TAO Qingsong, DING Yuan, HU Yingjie, XU Yifan, HU Yang, JIANG Zhengjie. Curative effect and prognosis of laparoscopic patch repair of esophageal hiatal hernia. West China Medical Journal, 2020, 35(3): 322-327. doi: 10.7507/1002-0179.201910119 Copy

1.	陈双, 周太成, 马宁. 食管裂孔疝修补——力求结构与功能的统一. 中华胃肠外科杂志, 2018, 21(7): 734-739.
2.	Shapiro M, Lee BE, Rutledge JR, et al. The use of standardized measures to predict and assess quality of life after laparoscopic hiatal hernia repair. Am Surg, 2018, 84(6): 789-795.
3.	Romano A, D’Amore D, Esposito G, et al. Characteristics and outcomes of laparoscopic surgery in patients with large hiatal hernia. A single center study. Int J Surg Case Rep, 2018, 48(48): 142-144.
4.	孙明明, 邵国益, 黄建明, 等. 腹腔镜疝修补联合 Nissen 胃底折叠术治疗食管裂孔疝. 中华胃食管反流病电子杂志, 2019, 6(1): 40-44.
5.	王勇, 段鑫, 罗文, 等. 腹腔镜食管裂孔疝修补术 12 例体会及操作要点分析. 中华胃食管反流病电子杂志, 2015, 2(1): 25-27.
6.	胡志伟, 陈美萍, 汪忠镐, 等. 短松 Nissen 胃底折叠术和 Toupet 胃底折叠术治疗胃食管反流病合并重度食管炎的对比研究. 临床外科杂志, 2018, 26(5): 349-353.
7.	李卓. 腹腔镜治疗食管裂孔疝的临床效果分析. 中国医药指南, 2019, 17(9): 142-143.
8.	王峰, 吴继敏, 汪忠镐, 等. 单中心腹腔镜食管裂孔疝修补术 992 例. 中华普通外科杂志, 2016, 31(9): 732-735.
9.	王春晓. 腹腔镜食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝合并胃食管反流的临床疗效观察. 中国临床新医学, 2018, 11(2): 164-167.
10.	李俊生, 张成, 嵇振岭, 等. 食管裂孔疝修补术中补片的应用及争议. 中华胃食管反流病电子杂志, 2015, 2(2): 102-104.
11.	Schmidt E, Shaligram A, Reynoso JF, et al. Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias. Dis Esophagus, 2014, 27(1): 13-17.
12.	牛刚, 王耿泽, 王建锋, 等. 腹腔镜下应用补片治疗食管裂孔疝的效果评估. 中国卫生标准管理, 2016, 7(13): 65-66.
13.	臧宇, 李晨, 田文. 无张力疝修补技术在腹腔镜食管裂孔疝修补中的应用. 解放军医学院学报, 2015, 36(7): 687-690.
14.	Jamieson GG. Results of laparoscopic antireflux surgery at five years and beyond. Bull Acad Natl Med, 2005, 189(7): 1519-1525.
15.	傅朝春, 徐安书, 张世博, 等. 腹腔镜下食管裂孔疝修补术的临床疗效分析. 华西医学, 2017, 32(3): 425-427.
16.	Tam V, Winger DG, Nason KS. A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair. Am J Surg, 2016, 211(1): 226-238.
17.	Koetje JH, Oor JE, Roks DJ, et al. Equal patient satisfaction, quality of life and objective recurrence rate after laparoscopic hiatal hernia repair with and without mesh. Surg Endosc, 2017, 31(9): 3673-3680.
18.	Oor JE, Roks DJ, Koetje JH, et al. Randomized clinical trial comparing laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh. Surg Endosc, 2018, 32(11): 4579-4589.
19.	Armijo PR, Pokala B, Misfeldt M, et al. Predictors of hiatal hernia recurrence after laparoscopic anti-reflux surgery with hiatal hernia repair: a prospective database analysis. J Gastrointest Surg, 2019, 23(4): 696-701.
20.	Oor JE, Koetje JH, Roks DJ, et al. Laparoscopic hiatal hernia repair in the elderly patient. World J Surg, 2016, 40(6): 1404-1411.
21.	Chevrollier GS, Brown AM, Keith SW, et al. Preoperative anemia: a common finding that predicts worse outcomes in patients undergoing primary hiatal hernia repair. Surg Endosc, 2019, 33(2): 535-542.
22.	Ilyashenko VV, Grubnyk VV, Grubnik VV. Laparoscopic management of large hiatal hernia: mesh method with the use of ProGrip mesh versus standard crural repair. Surg Endosc, 2018, 32(8): 3592-3598.
23.	陈震, 赵宏志, 王震宇, 等. 腹腔镜疝修补术治疗巨大食管裂孔疝 96 例临床分析. 中国实用外科杂志, 2017, 37(11): 1265-1268.
24.	常凯. 补片修补对比传统缝合修补治疗巨大食管裂孔疝的 Meta 分析. 苏州: 苏州大学, 2018.
25.	王艳, 胡晔东, 刘菲. 基于问卷的胃食管反流病症状评估量表. 胃肠病学, 2016, 21(11): 690-693.

1. 陈双, 周太成, 马宁. 食管裂孔疝修补——力求结构与功能的统一. 中华胃肠外科杂志, 2018, 21(7): 734-739.
2. Shapiro M, Lee BE, Rutledge JR, et al. The use of standardized measures to predict and assess quality of life after laparoscopic hiatal hernia repair. Am Surg, 2018, 84(6): 789-795.
3. Romano A, D’Amore D, Esposito G, et al. Characteristics and outcomes of laparoscopic surgery in patients with large hiatal hernia. A single center study. Int J Surg Case Rep, 2018, 48(48): 142-144.
4. 孙明明, 邵国益, 黄建明, 等. 腹腔镜疝修补联合 Nissen 胃底折叠术治疗食管裂孔疝. 中华胃食管反流病电子杂志, 2019, 6(1): 40-44.
5. 王勇, 段鑫, 罗文, 等. 腹腔镜食管裂孔疝修补术 12 例体会及操作要点分析. 中华胃食管反流病电子杂志, 2015, 2(1): 25-27.
6. 胡志伟, 陈美萍, 汪忠镐, 等. 短松 Nissen 胃底折叠术和 Toupet 胃底折叠术治疗胃食管反流病合并重度食管炎的对比研究. 临床外科杂志, 2018, 26(5): 349-353.
7. 李卓. 腹腔镜治疗食管裂孔疝的临床效果分析. 中国医药指南, 2019, 17(9): 142-143.
8. 王峰, 吴继敏, 汪忠镐, 等. 单中心腹腔镜食管裂孔疝修补术 992 例. 中华普通外科杂志, 2016, 31(9): 732-735.
9. 王春晓. 腹腔镜食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝合并胃食管反流的临床疗效观察. 中国临床新医学, 2018, 11(2): 164-167.
10. 李俊生, 张成, 嵇振岭, 等. 食管裂孔疝修补术中补片的应用及争议. 中华胃食管反流病电子杂志, 2015, 2(2): 102-104.
11. Schmidt E, Shaligram A, Reynoso JF, et al. Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias. Dis Esophagus, 2014, 27(1): 13-17.
12. 牛刚, 王耿泽, 王建锋, 等. 腹腔镜下应用补片治疗食管裂孔疝的效果评估. 中国卫生标准管理, 2016, 7(13): 65-66.
13. 臧宇, 李晨, 田文. 无张力疝修补技术在腹腔镜食管裂孔疝修补中的应用. 解放军医学院学报, 2015, 36(7): 687-690.
14. Jamieson GG. Results of laparoscopic antireflux surgery at five years and beyond. Bull Acad Natl Med, 2005, 189(7): 1519-1525.
15. 傅朝春, 徐安书, 张世博, 等. 腹腔镜下食管裂孔疝修补术的临床疗效分析. 华西医学, 2017, 32(3): 425-427.
16. Tam V, Winger DG, Nason KS. A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair. Am J Surg, 2016, 211(1): 226-238.
17. Koetje JH, Oor JE, Roks DJ, et al. Equal patient satisfaction, quality of life and objective recurrence rate after laparoscopic hiatal hernia repair with and without mesh. Surg Endosc, 2017, 31(9): 3673-3680.
18. Oor JE, Roks DJ, Koetje JH, et al. Randomized clinical trial comparing laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh. Surg Endosc, 2018, 32(11): 4579-4589.
19. Armijo PR, Pokala B, Misfeldt M, et al. Predictors of hiatal hernia recurrence after laparoscopic anti-reflux surgery with hiatal hernia repair: a prospective database analysis. J Gastrointest Surg, 2019, 23(4): 696-701.
20. Oor JE, Koetje JH, Roks DJ, et al. Laparoscopic hiatal hernia repair in the elderly patient. World J Surg, 2016, 40(6): 1404-1411.
21. Chevrollier GS, Brown AM, Keith SW, et al. Preoperative anemia: a common finding that predicts worse outcomes in patients undergoing primary hiatal hernia repair. Surg Endosc, 2019, 33(2): 535-542.
22. Ilyashenko VV, Grubnyk VV, Grubnik VV. Laparoscopic management of large hiatal hernia: mesh method with the use of ProGrip mesh versus standard crural repair. Surg Endosc, 2018, 32(8): 3592-3598.
23. 陈震, 赵宏志, 王震宇, 等. 腹腔镜疝修补术治疗巨大食管裂孔疝 96 例临床分析. 中国实用外科杂志, 2017, 37(11): 1265-1268.
24. 常凯. 补片修补对比传统缝合修补治疗巨大食管裂孔疝的 Meta 分析. 苏州: 苏州大学, 2018.
25. 王艳, 胡晔东, 刘菲. 基于问卷的胃食管反流病症状评估量表. 胃肠病学, 2016, 21(11): 690-693.

West China Medical Journal

Curative effect and prognosis of laparoscopic patch repair of esophageal hiatal hernia

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