[Consideration regarding 20 antireflux laparoscopic operations for hiatal hernia].
OBJECTIVE
To evaluate the clinical, therapeutical and evolutive aspects of the patients with hiatal hernia with laparoscopical approach.


METHODS
Retrospective analysis of 20 patients diagnosed with hiatal hernia and operated, laparoscopical, between 13.01.1999-10.04.2002.


RESULTS
At 18 cases (90%), were sliding hiatal hernia and at 2 cases (10%), were paraesophageal hiatal hernia. There were performed laparoscopical: 1 (5%) Dor anterior hemi-fundoplication, 4 (20%) Rosetti fundoplication, 3 (15%) Toupet posterior hemi-fundoplication and 11 (55%) Nissen fundoplication. For the dissection, the ultrasound scissors (Ultra-Shears) was used and for the suture of the both diaphragmatic crus and the wrap, the Endo-Stitch. There were reported 1 (5%) optional conversion and 3 cases (15%) with bleeding solved by clipping and hemostatic suture. No postoperative complications, deaths intra and postoperative were reported. The average duration of the intervention decreased in time, due to the experience, from 180 to 60 minutes, but in accordance with the complexity of the procedure (Nissen-Toupet-Dor). At 2 (10%) cases with Nissen fundoplication was reported a transitory dysphagia, which was remitted between 1-2 months. We noticed a decreasing of the duration of hospitalisation for the antireflux laparoscopical interventions, compared with the classic methodes.


CONCLUSIONS
There is a tendency of the laparoscopical approach of hiatal hernia to come the standard in the GERD, due to his minimal invasive character, significantly reducing costs and good postoperative results.
Secţia de Chirurgie Generală, Spitalul Militar de Urgenţă Prof. Dr. Agrippa Ionescu, Sector 1, str. Arhitect Ion Mincu nr. 7, Bucureşti. iuliucos@yahoo.com
I
I
Costan
L
L
Alecu
Adriana
A
Deacu
A
A
Paşcu
G
G
Corodeanu
A
A
Marin
F
F
Obrocea
D000328:Adult; D000368:Aged; D005260:Female; D018662:Fundoplication / Q000379:methods; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome