The role of laparoscopic Nissen, Hill, and Nissen-Hill hybrid repairs for uncomplicated gastroesophageal reflux disease.

The role of laparoscopic Nissen, Hill, and Nissen-Hill hybrid repairs for uncomplicated gastroesophageal reflux disease. Minerva Chir. 2018 Jul 23;: Authors: Shemmeri E, Aye RW Abstract There are several elements that constitute the lower esophageal barrier against reflux. What characterizes the abnormality seen in GERD is the loss of an effective barrier combined with refluxed gastric contents. Several techniques including those described by Nissen, Toupet and Hill have become options for reconstructing the physiologic barrier. In this paper, we describe our technique of performing laparoscopic Nissen, Hill and a combined Nissen + Hill hybrid repair for the management of uncomplicated GERD. In a randomized study comparing 46 laparoscopic Nissen to 46 laparoscopic Hill repairs, subjective and objective short term and long term (13 months) outcomes including use of antisecretory agents were equivalent. The number of failures requiring reoperation were also the same but the difference in failure types prompted us to examine the two techniques and fuse them into one to maximize the integrity of the lower esophageal barrier. A comparative study of the Nissen, Hill and hybrid repairs with 15-month follow up showed similar subjective and objective outcomes and specifically no increase in dysphagia for the combined repair. There was also a trend towards less recurrence the hybrid group. More recently, we studied our Nissen repairs and compa...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research