Clinical Study On The Treatment Of Hiatal Hernia Combined With Gastroesophageal Reflux Disease By Peroral Endoscopic Cardial Constriction

Objective To study the efficacy and safety of gastroesophageal reflux disease treated with esophageal hiatal hernia combined with gastroesophageal reflux disease under oral endoscopy.Methods Collected patients with hiatal hernia and gastroesophageal reflux disease who were admitted to the Department of Gastroenterology,Affiliated Hospital of Inner Mongolia Medical University from September 2018 to September 2020,and selected 31 patients who met the inclusion criteria and agreed to receive this treatment.The enrolled patients underwent gastroscopy,24-hour esophageal PH monitoring,esophageal motility examination,gastroesophageal reflux disease health-related quality of life assessment(GERD-HRQL)score,and gastroesophageal reflux disease questionnaire before and 6 months after surgery.(GERD-Q)score and survey of patients’ satisfaction with symptom improvement;comparative analysis of relevant data before and 6 months after surgery to determine the treatment of esophageal hiatal hernia with gastroesophageal reflex Efficacy and safety of abortion.Results The reflux symptoms of patients who successfully received HH-PECC treatment were significantly improved,and there were no complications such as perforation,bleeding,or dysphagia after the operation.After the operation,5(16.12%)people experienced post-sternal pain,and 14(45.16%)had a sensation of subxiphoid or posterior sternal tightening.The above symptoms were relieved within 2 weeks.Thirty-one patients completed the relevant examinations and questionnaire scores before and 6 months after the operation.The self-reported reflux symptoms of most patients were significantly improved after the operation,and the quality of life related to sleep and diet was improved.Among them,22 patients were satisfied,8 patients were fair,and 1 patient was not satisfied.The esophagitis mucosal damage was significantly improved and even returned to normal esophagus mucosa after gastroscopy at 6 months after surgery.Cardia laxity in some patients was better than before surgery.The GERD-HRQL,GERD-Q,and De Meester scores were significantly lower than those before the operation.The GERD-HRQL score was six months after the operation(Z=-4.865 P<0.01);the GERD-Q score was six months after the operation(Z=-4.890 P <0.01);De Meester score six months after operation(Z=-4.409 P < 0.05).24-hour esophageal PH monitoring of esophageal acid exposure PH<4 time percent six months after surgery(Z=-3.98 P<0.05);number of acid refluxes six months after surgery(Z=-4.194 P<0.05);long The number of reflux was six months after surgery(Z=-4.293P<0.05);the long reflux time was six months after surgery(Z=-4.103 P<0.05);the above data were all statistically significant(P<0.05).In the esophageal motility examination,the average resting pressure of the lower esophageal sphincter,the length of the lower esophageal sphincter,and the residual pressure of the lower esophageal sphincter were slightly improved compared with those before the operation,but there was no statistical significance(P>0.05).Conclusion HH-PECC has a reliable curative effect in the treatment of hiatal hernia combined with gastroesophageal reflux disease,and has promotion value;but the effect of banding depth,banding position,banding loop number,banding times,and size of esophageal hiatal hernia on the curative effect needs to be further studied.