Introduction: Hiatal hernia is one of the most common anatomical defects of the gastrointestinal tract and a benign disease of the cardioesophageal junction. It is often accompanied by gastroesophageal reflux disease. Laparoscopic fundoplication is accepted as the gold standard in its treatment and is widely used. An analysis of the results contributes to improving the method and reducing complications.
Aim: To conduct a study on the application of laparoscopic fundoplication in hiatal hernia.
Materials and Methods: The study included 362 patients who were diagnosed and operated on in the First Clinic of Surgery at St. Marina University Hospital in Varna, during the period 2005–2022. Perioperative results, morbidity, mortality, general and specific complications, as well as pre- and postoperative data according to the follow-up protocol, were analyzed.
Results: The distribution of the total group of patients by sex was 30.5% male and 69.5% female. The mean age of the patients was 62.0 years, with 59.1 years for men and 62.9 years for women. The majority of patients had mixed hiatal hernia (type III) (36.8%), followed by type IV (27.9%), type I (15.4%), and paraesophageal hiatal hernia (19.9%). The most commonly performed operative method for fundoplication was Nissen. Collis gastroplasty was also performed in 45 patients with evidence of brachioesophagus. Postoperative complications were considered according to the Dindo-Clavien classification. The recurrence rate was 11.1%. Statistical analysis found that after each intervention there was a significant change in the value of the GIQLI quality of life index. Data on specific complications and management are presented.
Conclusion: Laparoscopic fundoplication is a continuously evolving method. Functional outcomes, combined with low mortality and morbidity, ensure a good quality of life for patients.
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