Laparoscopic mesh-augmented hiatoplasty as a method to treat gastroesophageal reflux without fundoplication: single-center experience with 306 consecutive patients

Publication

Laparoscopic mesh-augmented hiatoplasty as a method to treat gastroesophageal reflux without fundoplication: single-center experience with 306 consecutive patients

Journal Paper/Review - Jul 1, 2009

Müller-Stich Beat P, Köninger Jörg, Müller-Stich Bettina H, Schäfer Fritz, Warschkow Rene, Mehrabi Arianeb, Gutt Carsten N

Citation

Müller-Stich B, Köninger J, Müller-Stich B, Schäfer F, Warschkow R, Mehrabi A, Gutt C. Laparoscopic mesh-augmented hiatoplasty as a method to treat gastroesophageal reflux without fundoplication: single-center experience with 306 consecutive patients. American journal of surgery 2009; 198:17-24.

Type

Journal Paper/Review (English)

Journal

American journal of surgery 2009; 198

Publication Date

Jul 1, 2009

Issn Electronic

1879-1883

Pages

17-24

Brief description/objective

BACKGROUND: Laparoscopic fundoplication represents the surgical standard treatment of gastroesophageal reflux disease. However, because of persisting side effects the method is not without controversy. Laparoscopic mesh-augmented hiatoplasty might be an alternative. METHODS: In 306 consecutive patients the perioperative course and symptomatic outcome was analyzed after a mean follow-up period of 52 months. RESULTS: The mean DeMeester symptom score decreased from 5.3 to 2.0 (P < .001). Acid-suppressive therapy on a regular basis was discontinued in 79% of patients. The gas bloating value decreased from .7 to .5 (P = .031), and the dysphagia value increased from .5 to .9 (P < .001). Belching and vomiting were possible in 93% and 88% of patients, respectively. Mesh-related complications with the need for reoperation occurred in 1% of patients. CONCLUSIONS: Laparoscopic mesh-augmented hiatoplasty is safe and does have an antireflux effect even without fundoplication. Side effects seem to be reasonable.