ABSTRACT
Background: Gastroesophageal reflux Disease is a highly prevalent gastrointestinal (GI) disorder and is one of the most common GI illnesses encountered in clinical practice. Gastroesophageal reflux disease (GERD) is one of the most common conditions presenting to primary care physicians and gastroenterologists. It refers to the abnormal exposure of the oesophageal mucosa to refluxed gastric contents, including acid and pepsin, resulting in symptoms and/or tissue damage. Our aim was to compare the result of nissen and toupet procedures and to determine which procedure is better in terms of symptomatic improvement symptom recurrence and post-operative complications. Materials and methods: This was the both prospective and retrospective study included 29 patients with GERD who were operated upon by Laproscopic Nissen Fundoplication and Laproscopic Posterior Fundoplication. Demographic and clinical profiles of all patients were recorded. All patients were subjected to thorough clinical evaluation, upper GI endoscopy done in all patients, esophageal Manometry and 24 ph study done in selected patients. All preoperative data compared with the postoperative data. Results: In our series 68.9% of the patients were below 50 years. 31.03% was above 50 years. The average age of occurrence was being 41.4 years. In our series Sex distribution were 75.8% of Males and 24.1% of Females. Wound (port site) infection 5 (17.2%) was treated with antibiotics and drainage, chest infection (atelectasis) 7 (24%) treated with IV antibiotics, Pleural effusion 2 (6.8%) was treated with physiotherapy settled down 2-3 days, mild surgical emphysema 2 (6.8%) may be due to good hiatal dissection and proper esophagus mobilization, it settled down in 2 days, urinary tract Patel Y, Baria B, Gohil K, Parmar H. Comparative study of Laparoscopic Nissen fundoplication Vs Posterior fundoplication in Gastroesophageal reflux disease. IAIM, 2016; 3(9): 189-193. Page 190 infection 3 (10.3%) was treated with antibiotics, port site hematoma 3 (10.3%) was managed conservatively. Conclusion: Both Laparoscopic Nissen fundoplication and Laparoscopic posterior fundoplication provides excellent results for GERD in terms of postoperative morbidity and complications.
ABSTRACT
Objective To investigate the clinical effects of laparoscopic repair of esophageal hiatal hernia using Bard CruraSoft PTFE/ePTFE Mesh combined with Toupet partial fundoplication.Methods From August 2006 to April 2007,13 patients with esophageal hiatal hernia(typeⅠin 6 and type Ⅲ in 7)were treated by laparoscopy in our hospital.Under a laparoscope,esophageal hiatal hernia was separated by ultrasonic scalpel,and then repaired using Bard CruraSoft PTFE/ePTFE Mesh with Ethicon Endopath Multifieed Stapler.Afterwards,Toupet partial fundoplication was performed.Results The operation was completed in all the cases without converting to open surgery.The mean operation time was 142 min(115-185 min);mean intraoperative blood loss was 75 ml(25-120 ml);mean time to the first flatus and oral feeding was 32 h(26-37 h);and mean postoperative hospital stay was 4 d(3-6 d).The patients were followed up for 4-11 mon(mean 6.5 mon).The symptoms disappeared in 1 month.Three months after the operation,barium examination found no recurrence of the hernia in the 13 cases.Conclusions Laparoscopic repair of esophageal hiatal hernia with mesh combined with Toupet partial fundoplication is a safe and minimally invasive operation.The method is worth being widely used.