Objective: To compare the efficacy of laparoscopic hernia repair combined with Nissen and Dor fundoplication in the treatment of senile esophageal hiatal hernia(HH). Methods: The clinical data of 149 patients with HH who underwent laparoscopic hernia repair and anti-reflux were retrospectively analyzed,including 94 patients of laparoscopic hernia repair combined with Nissen fundoplication(Nissen group),and 55 patients of laparoscopic hernia repair combined with Cor fundoplication(Cor group).The surgical condition and the postoperative complications between the two groups were compared,the scores of Gerd Q, DeMeester and QLQI were evaluated before surgery and 6 months after surgery. Results: The operation time and intraoperative blood loss in Nissign group were significantly higher than those in Dor group(P<0.05),but there was no significant difference in the recovery time and postoperative hospital stay between the two groups(P>0.05); 6 months after surgery, scores of GERD-Q and DeMeester were significantly decreased GLQI scores were significantly improved in the two groups(P<0.05),there was no significant difference of GERD-Q, DeMeester and GLQI scores in mild-moderate patients between the two groups(P>0.05),but these scores in severe patients in Nissen group were significantly better thanthose of the Dor group(P<0.05);The incidence of dysphagia in the Nissen group was 15.96%, significantly higher than 3.64% in the Dor group(P<0.05). Conclusion: Laparoscopic hernia repair combined with Nissen and Dor fundoplication safe and effective in the treatment of elderly patients with HH. Dor fundoplication has less postoperative dysphagia,while Nissen fundoplication has better curative effect for patients with severe esophageal acid reflux.
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