Laparoscopic V fundoplication in the treatment of hiatal hernia complicated with gastroesophageal reflux disease / 中国医师杂志

ABSTRACT

Objective:To investigate the effect and value of V-type fundoplication in the treatment of hiatal hernia with gastroesophageal reflux disease.Methods:From January 2012 to November 2018, a retrospective analysis was performed on 115 cases of patients with esophageal hiatal hernia and gastroesophageal reflux disease who underwent laparoscopic fundoplication in our hospital, including 68 cases of Nissen operation and 47 cases of type V-type stomach fundoplication. The information of surgical status, postoperative recovery, postoperative gastroesophageal reflux disease questionnaire (GERD-Q) score, and postoperative complications were collected and analyzed in these 2 groups.Results:Compared with Nissen technique, the operation time of V-shaped fundus plication was shortened, but the difference was not statistically significant ( P>0.05). There was no statistical difference in terms of indicators including intraoperative blood loss, postoperative drinking time, drainage tube extraction time, postoperative hospitalization time between two types of the operation ( P>0.05); the difference between the two groups was not statistically significant in the improvement of reflux symptoms, manometry and 24-hour pH result among the postoperative patients ( P>0.05); all the patients had no recurrence occurred; the incidence of dysphagia after surgery was significantly lower in V-shaped gastric fundus compared with Nissen operation, with statistically significant difference ( P<0.05); there was no statistical difference in the incidence of bloating, diarrhea, and constipation ( P>0.05). Conclusions:Laparoscopic V-shaped fundus fold surgery, as an anti-reflux technique, has the advantages of simple operation, clear results, fewer complications and easy standardization.