Comparison Of Postoperative Efficacy Of Laparoscopic Nissen And Toupet Fundoplication In The Treatment Of Esophageal Hiatal Hernia Complicated With Gastroesophageal Reflux Disease

Objective:To analyze the surgical effects of laparoscopic esophageal-hiatal hernia repair combined with Nissen and Toupet gastric fundoplica tion in the treatment of esophageal hiatal hernia complicated with gastro esophageal reflux disease,and to explore the advantages of each operati on.Methods: The clinical data of 87 cases of hiatal hernia with gastroesophageal reflux disease admitted to the 8th general surgery department from 2014 to October 2019 were collected,among which there were 38 patients received Nissen fundoplication(Niseen group);49 patients received Toupe t fundoplication(Toupet group).GERD-Q scores,recovery outcomes of esophagitis,and medication compliance of postoperative PPI,and rate of postoperative complication,time of operation,intraoperative blood loss,hospitalization days,and recovery time of gastrointestinal function were compared between the two groups before and 6 months after the surge ry.Results: The follow-up time of patients in the two groups ranged f rom 6 months to 12 months,with an median interval of 9 months.The re were no significant differences in age,gender,and distribution of pre operative symptom,and average hospitalization days,recovery time of g astrointestinal function,intraoperative blood loss and hospitalization days between the two groups(P>0.05).Analysis of follow-up information: T here was significant differences of postoperative GERD-Q score than tha t before the treatment in each group(P<0.05),but there was no differe nce between the two groups.There were no obvious improvements in comparing recovery outcomes of postoperative esophagitis and drug reduc tion and drug withdrawal of postoperative PPI in the two groups and w ith no statistical differences(P>0.05).There were two cases of postoper ative dysphagia in the Toupet group,which was higher than one case o f the Nissen group,and the difference between the two groups was stati stically significant.Conclusion: It can achieve a good clinical antireflux effect by laparoscopic hiat al hernia repair with antireflux procedure(laparoscopic Nissen and Toup et fundoplications).Both of the two procedures can be used as the choic e of anti-reflux surgery for patients with HH complicated with GERD.