[Surgical strategy in laparoscopic repair of hiatal hernia and procedures for gastroesophageal reflux].

The authors discuss about 68 celioscopy antireflux procedures, carried out for transhiatal hernia accompanied by gastroesophageal reflux, during a period of 8 years, between 1996 and 2003. The aim of this research is a clinical and technical comparative study, in fact between the posterior total or partial fundoplication and the anatomical procedures. In order to have a complete evaluation of the risks and results, the authors discuss the indications of each procedure, a series of specific intra and postoperative complications, including conversions and reinterventions, for each procedure. The authors also refer to the difficulty degree, the time required for each procedure, to find out the ways of improving these parameters. Although the number of patients is quite small, in this experience, posterior fundoplication seems easier and safer, whenever possible. The Nissen procedure, which technique is more laborious, seems to offer a better postoperative evolution and more long - lasting results in time.