Safety and efficacy of PTFE-mesh in laparoscopic fundoplication for gastroesophageal reflux and hiatal hernia

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

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Hiatal hernia, Barrett’s esophagus, and long-term symptom control after laparoscopic fundoplication for gastroesophageal reflux

Surgical Endoscopy ◽

10.1007/s00464-012-2328-y ◽

2012 ◽

Vol 26 (11) ◽

pp. 3225-3231 ◽

Cited By ~ 12

Author(s):

Johannes Miholic ◽

Joumanah Hafez ◽

Johannes Lenglinger ◽

Fritz Wrba ◽

Christiane Wischin ◽

...

Keyword(s):

Gastroesophageal Reflux ◽

Hiatal Hernia ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Laparoscopic Fundoplication ◽

Symptom Control

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Laparoscopic fundoplication for a case of esophageal hiatal hernia after gastroschisis repair

Surgical Case Reports ◽

10.1186/s40792-019-0725-3 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Ryuichiro Hirose ◽

Satoshi Obata ◽

Manabu Tojigamori ◽

Masatoshi Nakamura ◽

Shohei Taguchi ◽

...

Keyword(s):

Gastroesophageal Reflux ◽

Hiatal Hernia ◽

Laparoscopic Fundoplication ◽

Abdominal Wall Defect ◽

Male Infant ◽

Fascial Closure ◽

Wall Defect ◽

Esophageal Hiatal Hernia ◽

Frequent Vomiting ◽

Laparoscopic Nissen

Abstract Background Esophageal hiatal hernia and gastroesophageal reflux have been recognized as inevitable complications after the definitive gastroschisis operation. Patients with refractory gastroesophageal reflux require anti-reflux surgery; however, the surgical adhesions may complicate subsequent surgical therapy, especially in the cases treated by staged repair. Case presentation A male infant who showed a severe gastroesophageal reflux due to hiatal hernia after staged abdominal fascial closure of gastroschisis. In spite of continuous conservative management, frequent vomiting and hematemesis had become progressively worse at the age of 8 months. Laparoscopic Nissen fundoplication was attempted and completed with no adverse events. Conclusions Laparoscopic fundoplication may be applied, as a first-line approach, for the treatment of gastroesophageal reflux in this difficult group of patients, after the repair of congenital abdominal wall defect.

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