EARLY RESULTS OF LAPAROSCOPIC SUTURE CRUROPLASTY AND NISSEN FUNDOPLICATION IN PATIENTS WITH HIATAL HERNIA AND REFLUX ESOPHAGITIS

Year 2021, Volume: 30 Issue: 2, 110 - 112, 15.09.2021

Harun Karabacak , Ramazan Kozan

https://doi.org/10.34108/eujhs.724954

Abstract

The aim of study is to analysis the early results and effectiveness of laparoscopic primary crus repair and antireflux surgery, and to guide clinicians in the selection of surgical candidates and methods. Between June 2013 and June 2018, the data of patients who were operated due to hiatal hernia and reflux esophagitis were reviewed retrospectively. All patients were evaluated with manometry, 24-hour pH monitorization and en- doscopy before surgery. Routine endoscopic control was performed at postoperative 6th month. Demo- graphic characteristics, preoperative and postoperative endoscopy findings, and complications were recorded. Eighteen (56.2%) of the patients were male and 14 (43.8%) were female. Early complications were observed in 6 (18.8%) patients. Esophagitis was not observed in 28 (87.5%) of the patients at the endoscopic controls performed at the postoperative 6th month. According to the Los Angeles classification, esophagitis, which was preoperative grade C, decreased to grade A in 3 (9.4%) patients. In 1 (3.1%) patient, esophagitis persisted at the same severity as the preoperative period. At the end of the 6th month, none of the patients had dysphagia and recurrence. The combination of laparoscopic suture cruroplasty and Nissen fundoplication was found to be an effective treatment in terms of early complications and recurrence rates, as well as the treatment of esophagitis in hiatal hernia patients with reflux esophagitis.

Keywords

hiatal hernia, reflux esophagitis, Nissen fundoplication, suture cruroplasty, laparoscopy

HİATAL HERNİ VE REFLÜ ÖZOFAJİT BİRLİKTELİĞİNDE LAPAROSKOPİK SÜTÜR KRUROPLASTİ VE NİSSEN FUNDOPLİKASYONU’NUN ERKEN DÖNEM SONUÇLARI

Abstract

Bu
çalışmanın amacı laparoskopik primer krus onarımı ve antireflü cerrahisinin
erken dönem sonuçlarını ve etkinliğini irdelemek, cerrahi tedaviye aday
hastalar ve yöntem seçiminde klinisyenlere yol gösterici olmaktır. Haziran
2013 ile Haziran 2018 tarihleri arasında hiatal herni ve reflü özofajit
birlikteliği nedeni ile ameliyat edilen hastaların verileri retrospektif olarak
tarandı. Tüm hastalar ameliyat öncesinde özofagus manometrisi, 24 saatlik pH
monötörizasyonu ve üst gastrointestinal sistem endoskopisi ile değerlendirildi.
Ameliyat sonrası 6. ayda rutin endoskopik kontrol yapıldı. Hastaların
demografik özellikleri, ameliyat öncesi ve sonrası endoskopi bulguları ve
peroperatif komplikasyonlar kayıt altına alındı. Hastaların
18'i (%56.2) erkek, 14'ü (% 43.8) kadındı. Altı (%18.8) hastada erken
komplikasyon izlendi. Postoperatif 6. ayda yapılan endoskopik kontrollerde
hastaların 28'inde (%87.5) özofajit görülmedi. Üç hastada (%9.4) Los Angeles
sınıflandırmasına göre preoperatif grade C olan özofajitin grade A'ya
gerilediği görüldü. Bir  (%3.1) hastada
özofajit preoperatif dönem ile aynı şiddetde sebat etmekteydi.  Altıncı ayın sonunda hiçbir hastada disfaji
ve rekürrens saptanmadı. Laparoskopik
sütür kruroplasti ve Nissen fundoplikasyonu kombinasyonu reflü özofajiti olan
hiatal herni hastalarında özofajitin tedavisi yanı sıra erken dönem
komplikasyon ve rekürrens oranları yönünden de etkin bir tedavi olduğu görüldü.

Keywords

hiatal herni, reflü özofajit, Nissen fundoplikasyonu, sütür kruroplasti, laparoskopi

References

• 1. Chang CG, Thackeray L. Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience. JSLS 2016; 20. pii: e2015.00104.
• 2. Fein M, Ritter MP, DeMeester TR, et al. Role of the lower esophageal sphincter and hiatal hernia in the pathogenesis of gastroesophageal reflux disease. J Gastrointest Surg 1999; 3:405-410.
• 3. Bjelović M, Babic T, Gunjić D, Veselinović M, Spica B. Laparoscopic repair of hiatal hernias: experience after 200 consecutive cases. Srp Arh Celok Lek 2014; 142:424-430.
• 4. Stefanidis D, Hope WW, Kohn GP, et al. Guidelines for surgical treatment of gastroesophageal reflux disease. Surg Endosc 2010; 24:2647-2669.
• 5. Bello B, Zoccali M, Gullo R, et al. Gastroesophageal reflux disease and antireflux surgery. What is the proper preoperative work-up? J Gastrointest Surg 2013; 17:14-20.
• 6. Chu C, Du Q, Li C, et al. Ambulatory 24-hour multichannel intraluminal impedance-pH monitoring and high resolution endoscopy distinguish patients with non-erosive reflux disease from those with functional heartburn. PLoS One 2017; 6:12:e0175263.
• 7. Rumstadt B, Kähler G, Mickisch O, Schilling D. Gastric mesh erosion after hiatoplasty for recurrent paraesophageal hernia. Endoscopy 2008; 40:2:E70.
• 8. De Moor V, Zalcman M, Delhaye M, El Nakadi I. Complications of mesh repair in hiatal surgery: about 3 cases and review of the literature. Surg Laparosc Endosc Percutan Tech 2012; 22:e222-225.
• 9. Tatum RP, Shalhub S, Oelschlager BK, Pellegrini CA. Complications of PTFE mesh at the diaphragmatic hiatus. J Gastrointest Surg 2008; 12:953-957.
• 10. Oelschlager BK, Pellegrini CA, Hunter JG, et al. Biologic prosthesis to prevent recurrence after laparoscopic paraesophageal hernia repair: Long-term follow-up from a multicenter, prospective, randomized trial. J Am Coll Surg 2011; 213:461-468.