title: Laparoscopic mesh-augmented hiatoplasty as a method to treat gastroesophageal reflux without fundoplication: single-center experience with 306 consecutive patients.
abstract: BACKGROUND
  Laparoscopic fundoplication represents the surgical standard treatment of gastroesophageal reflux disease. However, because of persisting side effects the method is not without controversy. Laparoscopic mesh-augmented hiatoplasty might be an alternative.
  
  
  METHODS
  In 306 consecutive patients the perioperative course and symptomatic outcome was analyzed after a mean follow-up period of 52 months.
  
  
  RESULTS
  The mean DeMeester symptom score decreased from 5.3 to 2.0 (P < .001). Acid-suppressive therapy on a regular basis was discontinued in 79% of patients. The gas bloating value decreased from .7 to .5 (P = .031), and the dysphagia value increased from .5 to .9 (P < .001). Belching and vomiting were possible in 93% and 88% of patients, respectively. Mesh-related complications with the need for reoperation occurred in 1% of patients.
  
  
  CONCLUSIONS
  Laparoscopic mesh-augmented hiatoplasty is safe and does have an antireflux effect even without fundoplication. Side effects seem to be reasonable.
authors.affiliation: Department of General, Abdominal and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. beat.mueller@med.uni-heidelberg.de
authors.forename: Beat P
authors.initials: BP
authors.lastname: Müller-Stich
authors.forename: Jörg
authors.initials: J
authors.lastname: Köninger
authors.forename: Bettina H
authors.initials: BH
authors.lastname: Müller-Stich
authors.forename: Fritz
authors.initials: F
authors.lastname: Schäfer
authors.forename: René
authors.initials: R
authors.lastname: Warschkow
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.forename: Carsten N
authors.initials: CN
authors.lastname: Gutt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D004944:Esophagoplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013526:Surgical Mesh; D016896:Treatment Outcome; D055815:Young Adult