Clinical Efficacy Of Esophageal Hiatal Hernia Repair Combined With Nissen And Dor Fundoplication In The Treatment Of Esophageal Hiatal Hernia Combined With Gastroesophageal Reflux Disease

Objective:To investigate the surgical procedures for esophageal hiatal hernia combined with gastroesophageal reflux disease(GERD),and to compare the clinical efficacy of two different fundoplication procedures,Nissen and Dor,to provide a basis for physicians’ clinical decisions.Methods:Patients with esophageal hiatal hernia(HH)combined with gastroesophageal reflux disease(GERD)who visited the Sino-Japanese Union Hospital of Jilin University from January 2015 to October 2022 were collected,and those who were diagnosed with esophageal hiatal hernia combined with GERD and had indications for surgical treatment were excluded according to the inclusion criteria of this study,while those who might have an impact on the comparison results were excluded according to the exclusion criteria.The 44 surgical patients enrolled were divided into the Nissen group and Dor group according to the different fundoplication methods,including 24 patients in the Nissen group and 20 patients in the Dor group,and the clinical efficacy of the two procedures was evaluated by comparing and analyzing the general data,intraoperative and postoperative conditions,complications,and Gred Q scores of the patients in the two groups.Results:By comparative analysis,there were no statistically significant differences(P>0.05)between the two groups in preoperative general information,use of patch,choice of open or laparoscopic,and staging,excluding patient bias due to the above conditions for this study;the two groups differed in postoperative discharge days,recovery time of gastrointestinal function,postoperative pleural effusion,postoperative pneumonia,postoperative Gred Q score at 6 months,postoperative diarrhea,abdominal distension,and The differences were not statistically significant(P>0.05);in terms of operative time,the Nissen group had a significantly shorter operative time than the Dor group,and the differences were statistically significant(P<0.05);when comparing the preoperative and 6-month postoperative Gred Q scores of the two groups,the median postoperative Gred Q score in the Nissen group was 6(6,7)lower than the preoperative 9.5(8,12.75),and the median postoperative Gred Q score in the Dor group was 6.5(6,7.75)lower than the preoperative 9.5(9,12),with statistically significant differences(P<0.05).Conclusion: Esophageal hiatal hernia repair combined with Nissen and Dor fundoplication are both effective procedures for the treatment of esophageal hiatal hernia combined with gastroesophageal reflux disease,and both procedures can achieve good postoperative anti-reflux results.There was no significant difference in the short-term and long-term postoperative complications between the two procedures.