• Am. J. Surg. · Jun 2008

    Laparoscopic mesh-augmented hiatoplasty as a treatment of gastroesophageal reflux disease and hiatal hernias-preliminary clinical and functional results of a prospective case series.

    • Beat P Müller-Stich, Georg R Linke, Jan Borovicka, Francesco Marra, René Warschkow, Jochen Lange, Arianeb Mehrabi, Jörg Köninger, Carsten N Gutt, and Andreas Zerz.
    • Department of General, Abdominal and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. beat.mueller@gmx.net
    • Am. J. Surg. 2008 Jun 1;195(6):749-56.

    BackgroundBecause fundoplication-related side effects are frequent, we evaluated laparoscopic mesh-augemented hiatoplasty (LMAH) as a potential treatment option for gastroesophageal reflux disease and/or symptomatic hiatal herania. LMAH aims to prevent reflux solely by mesh-reinforced narrowing of the hiatus and lengthening of the intra-abdominal esophagus.MethodsTwenty-two consecutive patients with LMAH were evaluated prospectively using a modified Gastrointestinal Symptom Rating Scale questionnaire, pH measurement, manometry, and endoscopy. Follow-up was scheduled at 3 and 12 months after surgery.ResultsTotal reflux decreased from 16.3% before surgery to 3.5% 3 months after surgery (P = .001). The reflux score decreased from 3.8 before surgery to 2.1 1 year after surgery (P = .001). The respective values of the indigestion score were 3.4 and 2.0 (P < .001). After surgery, all patients were able to belch. Vomiting was impossible only for 2 patients, and 90% of patients assessed their results as good to excellent.ConclusionsLMAH seems to be feasible, safe, and has no significant side effects.

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