Hiatal hernia repair with Toupet fundoplication in surgical treatment of hiatal hernia, complicated by gastroesophageal reflux disease

Abstract

Introduction. Hiatal hernia occupies a third place in the structure of the gastrointestinal tract pathology. The association of hiatal hernia with gastroesophageal reflux disease can lead to severe complications and requires a surgical treatment. Objective. To analyze short-term and long-term results of a surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease (GERD). Methods. A retrospective analysis of the short-term and long-term treatment results of 62 patients suffering from hiatal hernia complicated by gastroesophageal reflux disease was performed. All the patients underwent a laparoscopic hiatal hernia repair supplemented by Toupet fundoplication. Results. The hospital stay duration was 7.21.6 days. The postoperative complication rate was 6.5%. Mild functional dysphagia was noted in 8(12.9%). Persistent long-term dysphagia in the late postoperative period was observed in 2(3.2%) patients. The recurrences of hiatal hernia or GERD were noted in 15(24.2%) patients in 5 years after the surgery. The total GERD-HRQL questionnaire score 5 years after the surgery was 5.73.9. Сonclusion. Laparoscopic interventions are safe, less traumatic, provide the possibility of early rehabilitation of patients, can achieve positive functional results in 85% of patients and should be used in the treatment of patients suffering from hiatal hernia complicated by GERD.

Keywords

• hiatal hernia
• gastroesophageal reflux disease
• laparoscopic repair