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Long-term outcome of laparoscopic Nissen-Rossetti fundoplication versus Thal fundoplication in children with esophageal hiatal hernia: a retrospective report from two children's medical centers in Shanghai

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World Journal of Pediatrics 2016年第2期12卷 231-235页

作者： Ji-Meng Hu Ming Hu Ye-Ming Wu Jun Wang Zhi-Long Yan Chi Zhang Wei-Hua Pan Hao Xia Department of Pediatric Surgery Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092China Department of Pediatric Surgery Shanghai Children's Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China

Background: This study was undertaken to investigatethe intraoperative and postoperative complications,efficacy and outcome of two laparoscopic fundoplicationsfor the treatment of esophageal hiatal hernia in ***: To find a rational procedure, we performeda retrospective analysis of 136 children with esophagealhiatal hernia who underwent laparoscopic Nissen-Rossettior Thal fundoplication at two children's hospitals inShanghai over 13 years. The median follow-up time of thechildren was 42 months (range: 1-138 months). Their agevaried from 1 month to 11 years (median: 18.6 months).Results: All the children underwent laparoscopicfundoplications (72 cases of Nissen-Rossetti and 60 casesof Thal fundoplication) and 4 children converted to opensurgery. The mean age of the children at the time ofoperation was 1.6±1.9 years, and the mean weight was9.1±5.6 kg. Gastroesophageal refl ux was signifi cantly moresevere after a Thal fundoplication (P=0.003) and slightesophageal stenosis was signifi cant after a Nissen-Rossettifundoplication (P=0.02). The recurrent rate of hiatal herniawas 2.8% (2/72) after Nissen-Rossetti fundoplication incontrast to 5% (3/60) after Thal fundoplication. No deathoccurred after ***: There was no statistical difference ofrecurrence between laparoscopic Nissen-Rossetti and Thalfundoplication in the long-term outcomes. The rate of slightdysphagia was higher in the Nissen-Rossetti group. TheThal group had a significantly higher recurrence rate ofgastroesophageal reflux. There still exited learning curvefor this procedure. The incidence rate of complications issignifi cantly related to the profi ciency of pediatric surgeon.

关键词： esophageal hiatal hernia fundoplication laparoscopy

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Laparoscopic Repair of esophageal hiatal hernia

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第2期31卷 231-234页

作者：马冰田文陈凛刘培发 Department of General Surgery General Hospital of People's Liberation Army

This study was to appraise safety and feasibility of laparoscopic approach and investigate the clinical effects of laparoscopic tension-free repair of esophageal hiatal hernia using mesh. From August 2006 to July 2009, 24 patients with esophageal hiatal hernia underwent laparoscopic repair. Twenty-three patients received laparoscopic tension-free repair using mesh, at the same time, Toupet or Dor partial fundoplication was performed. One patient was converted to open surgery. The average operating time was 90 min （70-210 min） and the blood loss was between 10-110 mL. There was no death. The mean postoperative hospital stay was 5 days （3-30 days）. During a follow-up period of 12-20 months （mean 15 months）, there was no recurrence of the hernia, and no complication with use of *** present study suggested that laparoscopic approach was secure and minimally invasive operation for esophageal hiatal hernia and the use of mesh could reduce recurrence rate.

关键词： esophageal hiatal hernia laparoscopy fundoplication mesh

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