St. Luke's University Health Network, 801, Ostrum Street, Bethlehem, PA, 18015, USA.
Beckley ARH Hospital, 306 Stanaford Rd, Beckley, WV, 25801, USA.
J Robot Surg. 2023 Feb;17(1):197-203. doi: 10.1007/s11701-022-01424-7. Epub 2022 May 22.
Gastroesophageal reflux disease (GERD) results in a total healthcare cost of 12.3 billion dollars to the United States annually. GERD is often seen with hiatal hernias. Our study aims to compare short-term functional outcomes and postoperative symptom relief afforded by hiatal hernia repair with transoral incisionless fundoplication (TIF), together known as hybrid repair, to those of hiatal hernia repair with surgical fundoplication (conventional repair). We performed a retrospective chart review on 112 consecutive patients who underwent robot assisted laparoscopic hiatal hernia repair at a community hospital by a single surgeon. We found that the short-term functional results and symptom relief with hybrid repair were no superior to those with conventional repair. We did not find a significant difference between hybrid and conventional repair in terms of in 30 day complications, ER visits or inpatients admissions. The number of patients who were symptomatic at delayed follow-up was not significantly different between both the groups. As such, short-term functional outcomes and symptom relief with hybrid hiatal hernia repair are no superior to those with conventional repair. Therefore, surgical repair of hiatal hernia with surgical fundoplication remains the standard of care until further data is available on long-term outcomes of the hybrid approach.
胃食管反流病（GERD）每年给美国造成的医疗总成本为 123 亿美元。GERD 常伴有食管裂孔疝。我们的研究旨在比较食管裂孔疝修补术联合经口无切口胃底折叠术（TIF，又称混合修补术）与单纯食管裂孔疝修补术（传统修补术）的短期功能结果和术后症状缓解情况。我们对一名外科医生在社区医院进行的 112 例连续机器人辅助腹腔镜食管裂孔疝修补术患者进行了回顾性图表审查。我们发现，混合修补术的短期功能结果和症状缓解与传统修补术没有显著差异。在 30 天内的并发症、急诊就诊或住院治疗方面，混合修补术与传统修补术之间也没有显著差异。在延迟随访时出现症状的患者数量在两组之间没有显著差异。因此，混合食管裂孔疝修补术的短期功能结果和症状缓解并不优于传统修补术。因此，在混合手术长期疗效的更多数据出现之前，手术修补食管裂孔疝并进行胃底折叠术仍然是标准治疗方法。
