Page 9 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
A Study to Evaluate Clinical Outcome of Laparoscopic Nissen

Fundoplication in Patients with Hiatus Hernia

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Aziz A Kaydawala , Rajesh D Patel , Dipen K Kotwal , Jayeshkumar B Bagada 4
Received on: 09 March 2023; Accepted on: 04 June 2023; Published on: 05 September 2023
AbstrAct
Introduction: Laparoscopic fundoplication is also important after medical management failure of gastroesophageal reflux disease. Nissen’s
fundoplication effectiveness is widely regarded as safe and effective, with a mortality rate of less than 1%. The purpose of this study is to assess
clinical outcomes after laparoscopic Nissen’s fundoplication in a patient with hiatus hernia and evaluate postoperative symptom relief, to
evaluate postoperative complications, and to evaluate postoperative improvement in patients’ lifestyles.
Materials and methodology: This retrospective observational study was conducted in civil hospital Ahmedabad for 30 patients admitted to
Civil Hospital, Ahmedabad from May 2019 to October 2021. The selection criteria for cases were based on the physical findings, clinical history,
radiological findings, and endoscopic findings. Patient information was collected from the medical record office. Sociodemographic variables
include age at diagnosis, marital status, religion, level of education, occupation, and socioeconomic status.
Results: In this study, the 51–60 years of age-group is affected mostly and the mean age is 56 years. Females are affected by around 53% as
compared with 47% of males. The most common presenting complaint is upper abdominal discomfort followed by heartburn, bloating, and
regurgitation. The usual day of discharge is day 3 or 4.
Conclusion: Laparoscopic Nissen fundoplication is the better surgery in patients with hiatus hernia with good clinical outcomes. Laparoscopic
Nissen fundoplication is an effective surgery for hiatus hernia with minimal complications in expert hands.
Keywords: Heartburn, Hiatus hernia, Nissen fundoplication.
World Journal of Laparoscopic Surgery (2023): 10.5005/jp-journals-10033-1555

IntroductIon 1–3 Department of General Surgery, BJ Medical College, Civil Hospital,
In this era of laparoscopy, a variety of surgeries are being done for a Ahmedabad, Gujarat, India
large number of abdominal pathologies, out of those, laparoscopic 4 Department of General Surgery, PSMC, Shree Krishna Hospital,
repair of hiatus hernia is one of the meticulous procedures that Karamsad, Anand, Gujarat, India
needs expertise. Laparoscopic fundoplication is also important Corresponding Author: Jayeshkumar B Bagada, Department of
after the failure of medical management of gastroesophageal reflux General Surgery, PSMC, Shree Krishna Hospital, Karamsad, Anand,
disease. Nissen’s fundoplication effectiveness is widely regarded as Gujarat, India, Phone: +91 7567104095, e-mail: jbagada@yahoo.in
safe and effective, with a mortality rate of less than 1%. How to cite this article: Kaydawala AA, Patel RD, Kotwal DK, et al.
In fundoplication, the stomach’s gastric fundus is wrapped A Study to Evaluate Clinical Outcome of Laparoscopic Nissen
around the lower end of the esophagus and sutured in place; Fundoplication in Patients with Hiatus Hernia. World J Lap Surg
therefore enhancing the closing function of the lower esophageal 2023;16(1):8–10.
sphincter. In order to prevent and cure a concurrent hiatal hernia, Source of support: Nil
in cases in which the fundus protrudes through an enlarged Conflict of interest: None
esophageal hiatus of the diaphragm, the esophageal hiatus
is constricted further with sutures. There are many types of
fundoplication. Commoners are Nissen (posterior 360 degrees), follow-up. The failure is caused equally by recurring reflux and
Dor (anterior 90–180 degrees), and Toupet (posterior 270 degrees). prolonged adverse effects.
The fundus is completely wrapped around the esophagus in
a Nissen fundoplication, which is also referred to as “complete MAterIAls And Methodology
fundoplication.” This procedure is now routinely performed The materials for the study of the outcome of laparoscopic Nissen
laparoscopically. The mechanism of comfort is that anytime the fundoplication were collected from cases admitted in Civil Hospital,
stomach contracts, the esophagus likewise closes up, preventing Ahmedabad from May 2019 to October 2021 clinically, 30 cases
stomach acid from entering it. Laparoscopic hiatal hernia repair have been studied. The criteria for the case selection were based
procedure has been shown to give good short- and long-term on physical findings, clinical history, endoscopic findings, and
outcomes in gastroesophageal reflux disease. 1,2 radiological findings.
Complications include dysphagia, gas bloat syndrome,
excessive scarring, dumping syndrome, rare achalasia, and vagus Study Design
nerve injury, Postoperatively irritable bowel syndrome that lasts Study type: Retrospective Observational study
roughly 2 weeks. A good outcome following Nissen fundoplication
may be expected in approximately 90% of the patients at 10 years Study site: Department of Surgery, Civil Hospital, Ahmedabad

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