Hiatal hernia repair with Toupet fundoplication in surgical treatment of hiatal hernia, complicated by gastroesophageal reflux disease

Cover Page

Cite item

Full Text

Abstract

Introduction. Hiatal hernia occupies a third place in the structure of the gastrointestinal tract pathology. The association of hiatal hernia with gastroesophageal reflux disease can lead to severe complications and requires a surgical treatment.

Objective. To analyze short-term and long-term results of a surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease (GERD).

Methods. A retrospective analysis of the short-term and long-term treatment results of 62 patients suffering from hiatal hernia complicated by gastroesophageal reflux disease was performed. All the patients underwent a laparoscopic hiatal hernia repair supplemented by Toupet fundoplication.

Results. The hospital stay duration was 7.2±1.6 days. The postoperative complication rate was 6.5%. Mild functional dysphagia was noted in 8(12.9%). Persistent long-term dysphagia in the late postoperative period was observed in 2(3.2%) patients. The recurrences of hiatal hernia or GERD were noted in 15(24.2%) patients in 5 years after the surgery. The total GERD-HRQL questionnaire score 5 years after the surgery was 5.7±3.9.

Сonclusion. Laparoscopic interventions are safe, less traumatic, provide the possibility of early rehabilitation of patients, can achieve positive functional results in 85% of patients and should be used in the treatment of patients suffering from hiatal hernia complicated by GERD.

About the authors

A. G. Grintcov

M. Gorky Donetsk National Medical University

Email: aggrintsov@gmail.com
ORCID iD: 0000-0001-9261-0313

д-р мед. наук, профессор, зав. кафедрой хирургии стоматологического факультета

Donetsk

R. V. Ishenko

Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia

Email: ishenkorv@rambler.ru

д-р мед. наук, зам. главного врача по хирургии

Russian Federation, Moscow

Igor V. Sovpel

M. Gorky Donetsk National Medical University; G.V. Bondar Republican Cancer Center

Author for correspondence.
Email: Sovpelman@gmail.com
ORCID iD: 0000-0001-8303-7340

канд. мед. наук, ассистент кафедры онкологии; зав. операционным отделением

Donetsk

O. V. Sovpel

M. Gorky Donetsk National Medical University; G.V. Bondar Republican Cancer Center

Email: sovpeloleg@gmail.com
ORCID iD: 0000-0003-0222-1627

д-р мед. наук, профессор кафедры онкологии

Donetsk

Ju. A. Shapovalova

G.V. Bondar Republican Cancer Center

Email: ninamed@list.ru
ORCID iD: 0000-0002-5220-5687

канд. мед. наук, ассистент кафедры онкологии

Donetsk

References

  1. Пучков К.В., Филимонов В.Б. Грыжи пищеводного отверстия диафрагмы. — М.: Медпрактика-М; 2003. — 171 с. [Puchkov KV, Filimonov VB. Gryzhi pishchevodnogo otverstiya diafragmy. Moscow: Medpraktika-M; 2003. 171 р. (In Russ).]
  2. Галимов О.В., Ханов В.О., Гаптракипов Э.Х. Новые технологии в хирургическом лечении гастроэзофагеальной рефлюксной болезни // Хирургия. Журнал им. Н.И. Пирогова. — 2007. — №2. — С. 29–33. [Galimov OV, Khanov VO, Gaptrakipov ЕKh. New technologies in the treatment of gastroesophageal reflux disease. Khirurgiia, Moskva. 2007;(2):29–33. (In Russ).]
  3. Родин А.Г., Базаев А. В, Никитенко А.И. Хирургическое лечение грыж пищеводного отверстия диафрагмы у больных пожилого возраста // Медицинский альманах. — 2014. — №3. — С. 117–120. [Rodin AG, Bazaev AV, Nikitenko AI. Surgical treatment of hiatal hernia of elderly patients. Meditsinskiy al’manakh. 2014;(3):117–120. (In Russ).]
  4. Сигал Е.И., Бурмистров М.В. Результаты лапароскопических операций при грыжах пищеводного отверстия диафрагмы // Анналы хирургии. — 2004. — №2. — С. 62–65. [Sigal YeI, Burmistrov MV. Results of laparoscopic surgery for hiatal hernia.Annals of surgery. 2004;(2):62–65. (In Russ).]
  5. Зябрева И.А., Джулай Т.Е. Грыжи пищеводного отверстия диафрагмы: спорные, нерешенные и перспективные аспекты проблемы (обзор литературы) // Верхневолжский медицинский журнал. — 2015. — Т.14. — №4. — С. 24–28. [Zyabreva IA, Dzhulay TE. Hiatal hernia: сontroversial, unsettled and PROspective ASPECTS (literature review). Upper Volga medical journal. 2015;14(4):24–28. (In Russ).]
  6. Мананников И.В. Эпидемиология гастроэзофагеальной рефлюксной болезни в Москве: Автореф. дис. … канд. мед.наук. — М.; 2005. — 26 с. [Manannikov IV. Epidemiologiya gastroezofageal’noy reflyuksnoy bolezni v Moskve. [dissertation abstract] Moscow; 2005. 26 р. (In Russ).] Доступно по: https://search.rsl.ru/ru/record/01003252493. Ссылка активна на 14.05.2019.
  7. Калинина Е.А., Пряхин А.Н. Технические аспекты лапароскопической пластики грыж пищеводного отверстия диафрагмы: обзор литературы и собственный опыт // Вестник Южно-Уральского государственного университета. Серия: Образование, здравоохранение, физическая культура. — 2014. — Т.14. — №3. — С. 54–60. [Kalinina EA, Pryakhin AN. Technical aspects of laparascopic hiatal hernia repair: literture review and own experience. Vestnik Yuzhno-Ural’skogo gosudarstvennogo universiteta. Seriya: Obrazovanie, zdravookhranenie, fizicheskaya kul’tura. 2014;14(3):54–60. (In Russ).]
  8. Грубник В.В., Малиновский А.В. Анализ отдаленных результатов лапароскопической пластики грыж пищеводного отверстия диафрагмы и фундопликации по Ниссену // Клиническая хирургия. — 2012. — №10. — С. 34–36. [Grubnik VV, Malinovskyi AV. Analysis of long-term results of laparoscopic repair of hiatal hernias and Nissen fundoplication. Klinicheskaya khirurgiya. 2012;(10):34–36. (In Russ).]
  9. Kohn GP, Price RR, DeMeester SR, et al. Guidelines for the management of hiatal hernia. Surg Endosc. 2013;27(12):4409–4428. doi: 10.1007/s00464-013-3173-3.
  10. Wileman SM, McCann S, Grant AM, et al. Medical versus surgical management for gastrooesophageal reflux disease (GORD) in adults. Cochrane Database Systematic Reviews. 2010 Mar 17;(3):CD003243. doi: 10.1002/14651858.CD003243.pub2
  11. Rickenbacher N, Kötter T, Kochen MM, et al. Fundoplication versus medical management of gastroesophageal reflux disease: systematic review and meta-analysis. Surg Endosc. 2014;28(1):143–155. doi: 10.1007/s00464-013-3140-z.
  12. Shan CX, Zhang W, Zheng XM, et al. Evidence-based appraisal in laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease. World J Gastroenterol. 2010;16(24):3063–3071. doi: 10.3748/wjg.v16.i24.3063.
  13. Kaplan JA, Schecter S, Lin MY, et al. Morbidity and mortality associated with elective or emergency paraesophageal hernia repair. JAMA Surg. 2015;150(11):1094–1096. doi: 10.1001/jamasurg.2015.1867.
  14. Jassim H, Seligman JT, Frelich M, et al. A population-based analysis of emergent versus elective paraesophageal hernia repair using the Nationwide Inpatient Sample. Surg Endosc. 2014;28(12):3473–3478. doi: 10.1007/s00464-014-3626-3.
  15. Dellaportas D, Papaconstantinou I, Nastos C, et al. Large paraesophageal hiatus hernia: is surgery mandatory? Chirurgia (Bucur). 2018;113(6):765–771. doi: 10.21614/chirurgia.113.6.765.
  16. Watson DI, Thompson SK, Devitt PG, et al. Laparoscopic repair of very large hiatus hernia with sutures versus absorbable mesh versus nonabsorbable mesh: a randomized controlled trial. Ann Surg. 2014;0(0):1e8. doi: 10.1097/SLA.00000 00000000842.
  17. Oelschlager BK, Pellegrini CA, Hunter JG, et al. Biologic prosthesis to prevent recurrence after laparoscopic paraesophageal hernia repair: long-term follow-up from a multicenter, prospective, randomized trial. J Am Coll Surg. 2011;213(4):461e468. doi: 10.1016/j.jamcollsurg. 2011.05.017
  18. Zhang C, Liu D, Li F, et al. Systematic review and meta-analysis of laparoscopic mesh versus suture repair of hiatus hernia: objective and subjective outcomes. Surg Endosc. 2017;31(12):4913–4922. doi: 10.1007/s00464-017-5586-x.
  19. Sathasivam R, Bussa G, Viswanath Y, et al. ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis. Asian J Surg. 2019;42(1):53–60. doi: 10.1016/j.asjsur.2018.05.001.
  20. Tam V, Winger DG, Nason KS. A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair. Am J Surg. 2016;211(1):226–238. doi: 10.1016/j.amjsurg.2015.07.007.
  21. Asti E, Lovece A, Bonavina L, et al. Laparoscopic management of large hiatus hernia: five-year cohort study and comparison of mesh-augmented versus standard crura repair. Surg Endosc Other Interv Tech. 2016;30(12):5404e5409. doi: 10.1007/s00464-016-4897-7.
  22. Velanovich V. Comparison of generic (SF-36) vs. disease-specific (GERD-HRQL) quality-of-life scales for gastroesophageal reflux disease. J Gastrointest Surg. 1998;2(2):141–145. doi: 10.1016/s1091-255x(98)80004-8.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Stages of surgical intervention

Download (630KB)
Indexing metadata

Copyright (c) 2019 Grintcov A.G., Ishenko R.V., Sovpel I.V., Sovpel O.V., Shapovalova J.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies