Clinical surgery—InternationalLaparoscopic mesh-augmented hiatoplasty as a treatment of gastroesophageal reflux disease and hiatal hernias–preliminary clinical and functional results of a prospective case series
Section snippets
Patients
Twenty-two consecutive patients who underwent LMAH at the Surgical Department of the Kantonsspital of St. Gallen were prospectively evaluated. Indications for surgery were either objectively proven GERD or symptomatic HH. Consequent therapy with proton-pump inhibitors (PPIs) for at least 3 months was required before surgery to give the patient the opportunity to make a decision for surgery in the context of adequate conservative therapy. Informed consent was obtained from every patient.
Preoperative data
The present patient series consisted of 9 male and 13 female patients with a mean age of 52 ± 18 years (range 20 to 82) and mean body mass index of 26 ± 4 kg/m2 (range 22 to 32). Characteristics did not significantly differ among patients with type I and those with types II and III HH except for age and American Society of Anesthesiologists score (Table 1).
Perioperative course
Mean surgcal time was 112 ± 25 minutes (range 70 to 160). It was shorter for patients with type I HH (97 ± 22.5 minutes) than for those with
Comments
When evaluating a potential surgical option for the treatment of GERD and symptomatic HH, besides feasibility and safety, the treatment option must be focused on symptomatic and objectified outcomes, which are represented by reflux scores, need for PPI treatment, side effects, normalization of esophageal pH, and healing of mucosal reflux lesions. Of course, success should be durable, meaning that recurrence is prevented. In our series, relief or improvement was achieved by LMAH for
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