Laparoscopic mesh-augmented hiatoplasty as a treatment of gastroesophageal reflux disease and hiatal hernias-preliminary clinical and functional results of a prospective case series.
BACKGROUND
Because fundoplication-related side effects are frequent, we evaluated laparoscopic mesh-augemented hiatoplasty (LMAH) as a potential treatment option for gastroesophageal reflux disease and/or symptomatic hiatal herania. LMAH aims to prevent reflux solely by mesh-reinforced narrowing of the hiatus and lengthening of the intra-abdominal esophagus.


METHODS
Twenty-two consecutive patients with LMAH were evaluated prospectively using a modified Gastrointestinal Symptom Rating Scale questionnaire, pH measurement, manometry, and endoscopy. Follow-up was scheduled at 3 and 12 months after surgery.


RESULTS
Total reflux decreased from 16.3% before surgery to 3.5% 3 months after surgery (P = .001). The reflux score decreased from 3.8 before surgery to 2.1 1 year after surgery (P = .001). The respective values of the indigestion score were 3.4 and 2.0 (P < .001). After surgery, all patients were able to belch. Vomiting was impossible only for 2 patients, and 90% of patients assessed their results as good to excellent.


CONCLUSIONS
LMAH seems to be feasible, safe, and has no significant side effects.
Müller-Stich
Beat P
BP
Department of General, Abdominal and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. beat.mueller@gmx.net
Linke
Georg R
GR
Borovicka
Jan
J
Marra
Francesco
F
Warschkow
René
R
Lange
Jochen
J
Mehrabi
Arianeb
A
Köninger
Jörg
J
Gutt
Carsten N
CN
Zerz
Andreas
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003964:Diaphragm / Q000601:surgery; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000601:surgery*; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013526:Surgical Mesh