title: Laparoscopic mesh-augmented hiatoplasty as a treatment of gastroesophageal reflux disease and hiatal hernias-preliminary clinical and functional results of a prospective case series.
abstract: 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.
authors: Department of General, Abdominal and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. beat.mueller@gmx.net
authors: Beat P
authors: BP
authors: Müller-Stich
authors: Georg R
authors: GR
authors: Linke
authors: Jan
authors: J
authors: Borovicka
authors: Francesco
authors: F
authors: Marra
authors: René
authors: R
authors: Warschkow
authors: Jochen
authors: J
authors: Lange
authors: Arianeb
authors: A
authors: Mehrabi
authors: Jörg
authors: J
authors: Köninger
authors: Carsten N
authors: CN
authors: Gutt
authors: Andreas
authors: A
authors: Zerz
mesh_terms: 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