title: [Clinical study of argon plasma coagulation combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia with Barrett esophagus].
abstract: OBJECTIVE
  To investigate the clinical efficacy of argon plasma coagulation (APC) combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia associated with Barrett esophagus.
  
  
  METHODS
  A total of 61 cases of hiatal hernias with Barrett esophagus from June 2010 to January 2014 in the Department of Minimal Invasive Surgery, Hernia and Abdominal wall Surgery, People's Hospital of Xinjiang Uyhur Autonomous Region were prospectively enrolled and were randomly allocated into two groups by computer system. Twenty-nine patients received esomeprazole 40 mg/d after APC treatment for 8 weeks (APC with medicine group). Thirty-two patients underwent laparoscopic hiatal hernia repair and Nissen fundoplication after APC treatment (APC with surgery group). All the patients were reviewed by gastroscope and pathologic examination at half a year and one year after operation respectively. Differences of disease improvement and recurrence between the two groups were evaluated.
  
  
  RESULTS
  In APC with medicine group, the Barrett's esophagus was relieved after one or two times of APC treatment, however, gastroscope and pathology revealed recurrence of Barrett's esophagus in 7 cases at half a year, and cumulative 16 cases of recurrences were detected after one year follow-up(16/29, 55.2%). In APC with surgery group, only one patient had recurrent Barrett's esophagus at half a year, and a total of two at one year follow-up by gastroscope examination(2/32, 6.3%). Significantly low recurrence rate of Barrett's esophagus was observed in APC with surgery group compared to APC with medicine group(P<0.01). Furthermore, recurrent hiatal hernia was detected in only one case in APC with surgery group. No esophageal cancer was found in both groups during follow-up.
  
  
  CONCLUSIONS
  APC combined with laparoscopic hiatal hernia repair and fundoplication is an ideal method for patients with hiatal hernia and Barrett's esophagus.
authors.affiliation: Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uyhur Autonomous Region, Urumqi 830001, China. klm6075@163.com.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Kelimu
authors.initials: K
authors.lastname: Abudureyimu
authors.forename: Yiliang
authors.initials: Y
authors.lastname: Li
authors.forename: Fuzeng
authors.initials: F
authors.lastname: Su
authors.forename: Huiling
authors.initials: H
authors.lastname: Li
authors.forename: Zhi
authors.initials: Z
authors.lastname: Wang
authors.forename: Zanlin
authors.initials: Z
authors.lastname: Li
authors.forename: Aikebaier
authors.initials: A
authors.lastname: Aili
authors.forename: Azhati
authors.initials: A
authors.lastname: Jiang
authors.forename: Alimu
authors.initials: A
authors.lastname: Jiang
mesh_terms: D057908:Argon Plasma Coagulation; D001471:Barrett Esophagus / Q000601:surgery*; D018662:Fundoplication; D005764:Gastroesophageal Reflux; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016896:Treatment Outcome