Abstract:
Objective To discuss the effect and postoperative complications of gastroesophageal reflux disease with hiatus hernia after fundoplication treatment of laparoscopic Nissen and Toupet.
Methods Review the 57patients with laparoscopic esophageal hiatal hernia complicated with gastroesophageal reflux disease which be treated with Nissen and Toupet fundoplication from July 2014 to July 2016 in Shengjing Hospital affiliated to China Medical University, 24 patients underwent Nissen surgery(group Nissen), 33 patients underwent Toupet operation(group Toupet). Observed and compare the anti reflux effect and postoperative complications of the two groups.
Results 57 cases were successfully completed laparoscopically, without laparotomy, the average operation time was (75.8±6.4)minutes(the total operation time was 68 minutes~115 minutes); the average amount of bleeding was (22±5)ml(the amount of bleeding was 15 to 30 ml); patch repair was used in the two methods; after 24 hours into the liquid, the mean postoperative hospitalization was (10.5±3)d.57cases were followed up for a period of 6 months to 2.5 years(mean, 18 months). None of the patients had regurgitation, heartburn and other typical symptoms of gastroesophageal reflux disease after the surgery.In group Nissen, dysphagia occurred in 2 patients(8.2%); In group Toupet, dysphagia occurred in 8 patients(24.2%). The incidence of postoperative complications in group Toupet was significantly higher than that in group Nissen.All patients with gastroesophageal reflux disease underwent gastroscopy before operation.They had different degrees of esophageal inflammation.All patients reexamined gastroscopy, esophageal manometry an esophageal 24 hours PH monitor.Review results showed: the pressure of the lower esophageal sphincter was significantly increased in the two groups after operation; the length of the lower esophageal sphincter was also significantly prolonged.
Conclusion laparoscopic Nissen surgery in the postoperative incidence of choke is better than the Toupet operation.But there was no significant difference between them.
Key words:
hernia, Hiatal,
Fundoplication,
Postoperative Complication
Qun Xu, Fuquan Yang, Jiaxin Liu, Zicheng Guo, Kun Xu, Xiangzhen Meng. Evaluation of laparoscoopic Nissen and Toupet fundopication in the treatment of gastroesophageal hiatal hernia complicated with gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2016, 03(04): 162-166.