The Efficacy of Laparoscopic Mesh Augmented Hiatoplasty Versus Laparoscopic Fundoplication in Treatment of Gastroesophageal Reflux Disease: A Comparative Study

Abstract

Background: An integral part of laparoscopic antireflux surgery for Gastroesophageal Reflux Disease (GERD) that has not responded to medication is fundoplication or mesh enhanced hiatoplasty. Finding out how laparoscopic mesh hiatus hernia repair and Nissen fundoplication fared in GERD patients was the primary goal of this research. Methods: This prospective randomized clinical trial included twenty-four individuals diagnosed with hiatal hernia. Group A had a laparoscopic hiatal hernia repair (HHR) procedure without fundoplication, and group B had an HHR procedure with Nissen fundoplication (HHR - LNF). The surgical procedure's duration, results, and potential risks complications were evaluated.Results: Number of reflux episodes in both group decreased from preoperative mean (91.2±17.8, 104.7±18.9) to (31±14.5, 18.5±10.3), number of lasting 5 minutes reflux episodes from preoperative mean (9.2±3.7, 9.8 ± 2.1) to postoperative (2.3±1.1, 0.3±0.02) and time of PH<4 form preoperative from (242.1±50.6, 261.5±57.8) to postoperative (97.3±45.1, 42.3±24.9) and also statistically significant improvement(increased) from preoperative (8.9±9.3, 9.3 ± 2.3) receptively to postoperative (14.2±7.8, 20.5±3.9 ) on resting LOS pressure. A higher operative time was revealed among group B than group A (p=0.007). Conclusion: Despite laparoscopic Nissen fundoplication was time consuming more than mesh augmented hiatoplasty, nearly same results were found in both techniques.