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.	陳雙, 周太成, 馬寧. 食管裂孔疝修補——力求結構與功能的統一. 中華胃腸外科雜志, 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.	孫明明, 邵國益, 黃建明, 等. 腹腔鏡疝修補聯合 Nissen 胃底折疊術治療食管裂孔疝. 中華胃食管反流病電子雜志, 2019, 6(1): 40-44.
5.	王勇, 段鑫, 羅文, 等. 腹腔鏡食管裂孔疝修補術 12 例體會及操作要點分析. 中華胃食管反流病電子雜志, 2015, 2(1): 25-27.
6.	胡志偉, 陳美萍, 汪忠鎬, 等. 短松 Nissen 胃底折疊術和 Toupet 胃底折疊術治療胃食管反流病合并重度食管炎的對比研究. 臨床外科雜志, 2018, 26(5): 349-353.
7.	李卓. 腹腔鏡治療食管裂孔疝的臨床效果分析. 中國醫藥指南, 2019, 17(9): 142-143.
8.	王峰, 吳繼敏, 汪忠鎬, 等. 單中心腹腔鏡食管裂孔疝修補術 992 例. 中華普通外科雜志, 2016, 31(9): 732-735.
9.	王春曉. 腹腔鏡食管裂孔疝修補聯合胃底折疊術治療食管裂孔疝合并胃食管反流的臨床療效觀察. 中國臨床新醫學, 2018, 11(2): 164-167.
10.	李俊生, 張成, 嵇振嶺, 等. 食管裂孔疝修補術中補片的應用及爭議. 中華胃食管反流病電子雜志, 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.	牛剛, 王耿澤, 王建鋒, 等. 腹腔鏡下應用補片治療食管裂孔疝的效果評估. 中國衛生標準管理, 2016, 7(13): 65-66.
13.	臧宇, 李晨, 田文. 無張力疝修補技術在腹腔鏡食管裂孔疝修補中的應用. 解放軍醫學院學報, 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, 徐安書, 張世博, 等. 腹腔鏡下食管裂孔疝修補術的臨床療效分析. 華西醫學, 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.	陳震, 趙宏志, 王震宇, 等. 腹腔鏡疝修補術治療巨大食管裂孔疝 96 例臨床分析. 中國實用外科雜志, 2017, 37(11): 1265-1268.
24.	常凱. 補片修補對比傳統縫合修補治療巨大食管裂孔疝的 Meta 分析. 蘇州: 蘇州大學, 2018.
25.	王艷, 胡曄東, 劉菲. 基于問卷的胃食管反流病癥狀評估量表. 胃腸病學, 2016, 21(11): 690-693.

1. 陳雙, 周太成, 馬寧. 食管裂孔疝修補——力求結構與功能的統一. 中華胃腸外科雜志, 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. 孫明明, 邵國益, 黃建明, 等. 腹腔鏡疝修補聯合 Nissen 胃底折疊術治療食管裂孔疝. 中華胃食管反流病電子雜志, 2019, 6(1): 40-44.
5. 王勇, 段鑫, 羅文, 等. 腹腔鏡食管裂孔疝修補術 12 例體會及操作要點分析. 中華胃食管反流病電子雜志, 2015, 2(1): 25-27.
6. 胡志偉, 陳美萍, 汪忠鎬, 等. 短松 Nissen 胃底折疊術和 Toupet 胃底折疊術治療胃食管反流病合并重度食管炎的對比研究. 臨床外科雜志, 2018, 26(5): 349-353.
7. 李卓. 腹腔鏡治療食管裂孔疝的臨床效果分析. 中國醫藥指南, 2019, 17(9): 142-143.
8. 王峰, 吳繼敏, 汪忠鎬, 等. 單中心腹腔鏡食管裂孔疝修補術 992 例. 中華普通外科雜志, 2016, 31(9): 732-735.
9. 王春曉. 腹腔鏡食管裂孔疝修補聯合胃底折疊術治療食管裂孔疝合并胃食管反流的臨床療效觀察. 中國臨床新醫學, 2018, 11(2): 164-167.
10. 李俊生, 張成, 嵇振嶺, 等. 食管裂孔疝修補術中補片的應用及爭議. 中華胃食管反流病電子雜志, 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. 牛剛, 王耿澤, 王建鋒, 等. 腹腔鏡下應用補片治療食管裂孔疝的效果評估. 中國衛生標準管理, 2016, 7(13): 65-66.
13. 臧宇, 李晨, 田文. 無張力疝修補技術在腹腔鏡食管裂孔疝修補中的應用. 解放軍醫學院學報, 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, 徐安書, 張世博, 等. 腹腔鏡下食管裂孔疝修補術的臨床療效分析. 華西醫學, 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. 陳震, 趙宏志, 王震宇, 等. 腹腔鏡疝修補術治療巨大食管裂孔疝 96 例臨床分析. 中國實用外科雜志, 2017, 37(11): 1265-1268.
24. 常凱. 補片修補對比傳統縫合修補治療巨大食管裂孔疝的 Meta 分析. 蘇州: 蘇州大學, 2018.
25. 王艷, 胡曄東, 劉菲. 基于問卷的胃食管反流病癥狀評估量表. 胃腸病學, 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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