Z Gastroenterol 2005; 43 - 132
DOI: 10.1055/s-2005-869779

Early post operative clinical and functional results after laparoscopic antireflux procedure in GERD patients with hiatal hernia

K Szentpáli 1, A Rosztóczy 2, A Paszt 1, F Izbéki 2, T Wittmann 2, S Ábrahám 1, A Wolfárd 1, J Lonovics 2, G Lázár 1
  • 1Sebészeti Klinika SZTE ÁOK, Szeged
  • 2I.sz. Belgyógyászati Klinika SZTE ÁOK, Szeged

Introduction/aims: GERD complicated with hiatal hernia constitutes a technically more difficult approach and it may influences the functional results of therapy. The authors analyzed the clinical outcomes and early follow up results of laparoscopic antireflux operations for GERD patients with or without hiatal hernia.

Material and methods: Between 1st of January 2000 and 31th of december 2004, 90 laporoscopic Nissen fundoplication were performed in our surgical department. 30 patients were excluded because of insufficient follow up. Patients were allocated into two groups: group 1 patients with hiatal hernia (n=44); group 2 without hiatal hernia (n=16). The pre- and post-operative (3 months) endoscopic, pH. metric, manometric, barium swallow results and clinical symptoms were analyzed.

Results: All parameters measured have showed significant improvement in both groups (except for transient post-operative dysphagia; group 1=12.5%; group 2=20.4%). The endoscopic findings (LosAngeles score) increased 93.7% and 95.4% in group 1 and 2, respectively. The length and degree of reflux episodes decreased by 87.5% and 86.3% in group 1 and 2, respectively. The manometry changes was nearly the same in both groups (group 1=93.7% and group 2=93.1%). Moreover, the presence of an accompanying hiatal hernia did not markedly prolong operative time.

Conclusion: Patients with hiatal hernia do not significantly differ in terms of early post-operative results. As such, hiatal hernia does not imply reduced functional and subjective post-operative outcome.