To compare the efficacy of simple suture and mesh repair for esophageal hiatal hernia and to evaluate recurrence and complications.

The study retrospectively included 77 patients with gastroesophageal reflux disease who underwent laparoscopic esophageal hiatal hernia repair from January 2002 to December 2012. According to the application of mesh reinforcement, patients were divided to 2 groups. Thirty-one patients who underwent simple suture were allocated into A group while 46 patients who underwent mesh reinforcement were allocated into B group. Recurrence and complications were both evaluated.

For the short-term results, Visick score was higher in B group compared with that in A group (P=0.007). Reflux symptoms significantly improve. Hiatal hernia recurrence was higher in A group compared with B group, but without significantly difference. Postoperative dysphagia failed to show significantly statistical difference between 2 groups. For the long-term results, degree of operative satisfaction was significantly higher in B group compared with A group (P=0.019). Recurrence of hiatal hernia was higher in A group, which tends to be a significantly statistical difference (P=0.05). The rate of postoperative dysphagia was not significantly different between 2 groups.

Mesh reinforcement of hiatal hernia could significantly relief reflux-related symptoms, improve degree of operative satisfaction and decrease risk of recurrence of hiatal hernia. However, mesh-related complications did not increase. The improvement of mesh texture, indication and repair techniques contribute to these results.