Comparation Between Laparoscopic Dor And Nissen Fundoplication In The Treatment Of Hiatal Hernia Combined With GERD

Objectives: To compare two anti-reflux procedures(laparoscopic anterior 180° partial fundoplication and Nissen fundoplication)in patients with gastroesophageal reflux disease(GERD). Methods:From Sept. 2013 to Jan. 2015, 82 patients of hiatal hernia combined with GERD were admitted in in the department of Minimally Invasive Surgery in Xinjiang people Hospital. All the patients were allocated into two groups selectively. Thirty-three patients were performed laparoscopic anterior 180° partial fundoplication(Dor group) and the other 49 patients were performed Nissen fundoplication(Nissen group). Perioperative clinical parameters were recorded for comparing efficacy between two groups. Results: Laparoscopic surgery was accomplished in all patients. The symptoms in most patients were adequately relieved after operation. Endoscopy, radiology, esophageal manometry and 24-hour pH monitoring were repeated 3 months after surgery. All the results returned to normal compared with preoperative data. A total of 82 patients got follow-up. During follow-up period of 3-24 months(mean12.5 months), there was no statistical significance between groups for the recurrence rate and satisfaction rate of operation. There was a lower incidence of dysphagia and epigastric bloating in the 360° group.Conclusion: For patients with GERD, laparoscopic anterior 180°partial fundoplication has a good and durable anti-reflux effect compared with laparoscopic Nissen fundoplication. With shorter operation time and lower incidence of postoperative complications(dysphagia and epigastric bloating) compared with Nissen fundoplication,laparoscopic anterior 180° partial fundoplication can be employed as a more appropriate procedure for treatment of GERD associated with HH.