Follow-Up Report of Laparoscopic Fundoplication in Different Types of Esophageal Hiatal Hernia in Children

Abstract

Abstract

Background:

Esophageal hiatal hernia can be classified into four types. It has been reported that most complications occurred in type II–IV hernia patients compared with type I hernia. This study aimed to investigate and compare the efficacy, complications, and long-time outcomes after laparoscopic fundoplication between type I and type II–IV hernia patients.

Materials and Methods:

Medical records of 110 children who underwent laparoscopic fundoplication during 2008–2017 in our institution were retrospectively analyzed. Information of postoperative symptoms, complications, and quality of life (QOL) were compared between different types.

Results:

All 110 children underwent laparoscopic fundoplication, and none converted to open surgery. Type I and type II–IV each accounted for 50.9% and 42.8%. There was no significant difference in the perioperative data between type I and type II–IV esophageal hiatal hernia. The follow-up information of 81 children was obtained. The scores of postoperative symptoms were comparable between type I and type II–IV group, except the severity score of reflux symptom was higher in type I hernia patients (P = .032). The difference in the incidence of postoperative complications and recurrence after laparoscopic fundoplication between type I and type II–IV hernia was not significant. The QOL in three aspects improved significantly after laparoscopic fundoplication in all types of esophageal hiatal hernia.

Conclusions:

Laparoscopic fundoplication was an effective approach for all types of esophageal hiatal hernia. Type II–IV hernia could obtain a comparable therapeutic effect and long-time outcome compared with type I hernia despite its increased complexity of the anatomy and the required laparoscopic repair procedure.