Comparison Of Dysphagia After Nissen Fundoplication And Toupet Fundoplication In The Laparoscopic Hiatal Hernia Repair

OBJECTIVE: To comparison the incidence rate of dysphagia of Nissen fundoplication and Toupet fundoplication in the laparoscopic hiatal hernia repair.METHODS: The clinical data of 137 patients who underwent laparoscopic hiatal hernia repair from February 2010 to February 2014 at our hospital were retrospectively analyzed,including 62 cases of Nissen fundoplication and 75 cases of Toupet fundoplication.The ages of patients were 33-71 years,mean age was 57.1±11.2 years old.RESULTS: all operations were performed,no patient was converted to an open procedure.After the follow up period of 4 months to 36 months.Ten patients have had dysphagia after operation in Nissen group(The incidence rate of dysphagia was 16.13%),and four patients have had dysphagia after operation in Toupet group(The incidence rate of dysphagia was 5.33%).In Nissen group,the mean opration time was 110.55±10.17 minutes,the mean intraoperative bleeding was 31.23±3.22 ml, the mean postoperative Demeester score was 10.3±4.6 points, the mean hospital stay was 5.11±1.34 days,the incidence of postoperative reflux was 4.84%; and in Toupet group, the mean opration time was 112.46±12.55 minutes,the mean intraoperative bleeding was 30.16±3.18 ml, the mean postoperative Demeester score was 11.2±3.5 points, the mean hospital stay was 5.04±1.27 days,the incidence of postoperative reflux was 9.33%.The incidence rate of dysphagia after operation in Nissen fundoplication group was significantly higher than in Toupet fundoplication group(P<0.05).CONCLUSIONS: The incidence rate of dysphagia of Nissen fundoplication was significantly higher than that of Toupet fundoplication in the laparoscopic hiatal hernia repair.