COMPARISON BETWEEN LAPAROSCOPIC HIATAL HERNIA REPAIR WITH AND WITHOUT FUNDOPLICATION

Abstract

Background: A hiatal hernia is a type of hernia in which abdominal organs (typically the stomach) slip through
the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease
(GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or
heartburn. Other symptoms may include trouble swallowing and chest pains. This study aimed to compare
laparoscopic HHR cruroplasty (the effect of hernia reduction and only repair of diaphragmatic crura) versus
HHR with concomitant fundoplication in terms of relative frequency and severity of symptoms before
laparoscopic antireflux surgery, and DeMeester scores (DMS), relative symptom improvement, patients’
satisfaction, and complications after antireflux surgery . Patients and methods: This prospective randomized
study was conducted in GIT unit of General Surgery Department, Faculty of Medicine, Zagazig University, on
18 patients with hiatal hernia underwent laparoscopic hiatal hernia repair divided into two equal groups; 1st
group was laparoscopic hiatal hernia repair (HHR) without fundoplication and 2nd group was with Nissen
Fundoplication (HHR – LNF). Results: we found that there was complete absence of hernia among HHE-LNF
group (0.0 %) versus 2 patients (22.2 %) had persistent hernia after HHR group with no significance difference
between both groups pre- and post-operatively. There was not a statistically significance difference between the
two studied groups regarding success rate with 100.0% versus 77.8% among HHR_LNF and HHR respectively.
Conclusion: that laparoscopic hiatal hernia repair with Nissen Fundoplication has better short-term outcome
than without Nissen fundoplication.