Publication
Efficacy of laparoscopic mesh-augmented hiatoplasty in GERD and symptomatic hiatal hernia. Study using combined impedance-pH monitoring
Journal Paper/Review - May 1, 2008
Linke Georg R, Zerz Andreas, Tutuian Radu, Marra Francesco, Warschkow Rene, Müller-Stich Beat P, Borovicka Jan
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PubMed
Doi
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Journal
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Issn Print
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Brief description/objective
BACKGROUND: Laparoscopic fundoplication is the standard antireflux procedure. However, side effects such as gas bloating indicate that the procedure is not unproblematic. Laparoscopic mesh-augmented hiatoplasty (LMAH) might be an alternative operation aimed at restoring the intra-abdominal part of the esophagus and reducing the size of the diaphragmatic hiatus. AIM: The aim of this study was to prospectively evaluate gastroesophageal reflux disease symptoms and gastroesophageal reflux before and after LMAH using 24 h impedance-pH monitoring (MII-pH). MATERIALS AND METHODS: Twenty patients underwent MII-pH monitoring pre- and 3 months post-LMAH. Symptoms were assessed using the Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: LMAH reduced the mean (SD) reflux syndrome score [pre-op 4.5 (1.7) vs post-op 1.4 (0.9); p<0.001], median (25th-75th percentile) distal %time pH<4 [4.9 (3.4-10.3) vs 1.0 (0.3-2.5) %; p=0.001) and total number of liquid reflux episodes [27.5 (17.5-38.3) vs 18 (7.3-29.3); p<0.05] without changing the number of gas reflux episodes [12 (6-34.3) vs 13.5 (6-20); p=0.346). All patients reported no limitation of their ability to belch. CONCLUSION: LMAH significantly reduces reflux symptoms and esophageal acid exposure without interfering with the ability to vent gas from the stomach documented by an unchanged number of gas reflux episodes before and after LMAH.