Mid-term efficacy analysis of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia: A single-center retrospective study

doi:10.3877/cma.j.issn.1674-392X.2026.03.008

Abstract

Abstract:

Objective

To explore the mid-term efficacy of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia.

Methods

This study is a retrospective case series study. A total of 62 patients with typeⅢ hiatal hernia who underwent laparoscopic hiatal hernia repair with synthetic mesh in the Center for Obesity and Hernia Surgery , Department of General Surgery, Huashan Hospital, Fudan University from January 2017 to December 2023 were included. The perioperative conditions, postoperative complications, and follow-up results of the patients were analyzed.

Results

All 62 patients successfully completed laparoscopic surgery without conversion to open surgery. The average operation time was (114.5±35.7) minutes, and the average postoperative hospital stay was 5.0(4.0, 6.0) days. The average follow-up period was (72±24.6) months. The GerdQ score after surgery was significantly lower than that before surgery [(6.4±1.0) points vs (8.6±2.1) points, P<0.05], and the number of patients requiring proton pump inhibitor treatment significantly decreased (7 vs 41). The postoperative anatomical recurrence rate was 8.2% (5/61), the symptom recurrence rate was 8.2% (5/61), and the incidence of dysphagia was 16.4% (10/61). Patient-related factors were not significantly correlated with recurrence or dysphagia.

Conclusion

Laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia is safe and feasible. It can effectively improve clinical symptoms, and reduce the risk of recurrence.

Key words: Hernia, hiatal, Laparoscopy, Mesh repair, Recurrence, Dysphagia

Xiaojian Fu, Xianjue Huang, Yuxiao Chu, Zhiyuan Zhu, Qiyuan Yao, Rong Hua. Mid-term efficacy analysis of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia: A single-center retrospective study[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(03): 284-288.

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References 23

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项目	数值
性别[例(%)]
男性	27(43.5)
女性	35(56.5)
年龄(岁,±s)	65.8±13.7
贫血[例(%)]^a	17(27.4)
体重指数(kg/m²,±s)	24.2±3.7
GerdQ评分(分,±s)	8.6±2.1
疝类型[例(%)]
原发疝	50(80.6)
复发疝	12(19.4)
ASA分级[例(%)]
Ⅰ	31(50.0)
Ⅱ	28(45.2)
Ⅲ	3(4.8)
症状[例(%)]
烧心	23(37.2)
反流	45(72.6)
胸痛	11(17.7)
咳嗽	2(3.2)
吞咽困难	5(8.1)
胃镜LA分级[例(%)]
未见食管炎	33(53.2)
Grade A	16(25.8)
Grade B	6(9.7)
Grade C	3(4.8)
Grade D	3(4.8)
Barrett食管炎	1(1.6)

项目	数值
性别[例(%)]
男性	27(43.5)
女性	35(56.5)
年龄(岁,±s)	65.8±13.7
贫血[例(%)]^a	17(27.4)
体重指数(kg/m²,±s)	24.2±3.7
GerdQ评分(分,±s)	8.6±2.1
疝类型[例(%)]
原发疝	50(80.6)
复发疝	12(19.4)
ASA分级[例(%)]
Ⅰ	31(50.0)
Ⅱ	28(45.2)
Ⅲ	3(4.8)
症状[例(%)]
烧心	23(37.2)
反流	45(72.6)
胸痛	11(17.7)
咳嗽	2(3.2)
吞咽困难	5(8.1)
胃镜LA分级[例(%)]
未见食管炎	33(53.2)
Grade A	16(25.8)
Grade B	6(9.7)
Grade C	3(4.8)
Grade D	3(4.8)
Barrett食管炎	1(1.6)

项目	数值
手术类型[例(%)]
择期	62(100.0)
急诊	0(0.0)
手术入路[例(%)]
腹腔镜	62(100.0)
中转开放	0(0.0)
折叠类型[例(%)]
Nissen	56(90.3)
Toupet	3(4.8)
未做折叠	3(4.8)
手术时间(min,±s)	114.5±35.7
裂孔大小(cm,±s)	4.3±1.7
裂孔≥4 cm[例(%)]	49(79.0)
膈肌脚缝合针数(±s)	4.0±1.7
折叠袢缝合针数(±s)	2.8±1.3
术后住院时间[M(IQR)]	5.0(4.0, 6.0)
术中及短期并发症[例(%)]
胸膜损伤	18(29.0)
出血二次手术后死亡	1(1.6)
胸腔积液穿刺	1(1.6)
30天内再入院	1(1.6)

项目	数值
手术类型[例(%)]
择期	62(100.0)
急诊	0(0.0)
手术入路[例(%)]
腹腔镜	62(100.0)
中转开放	0(0.0)
折叠类型[例(%)]
Nissen	56(90.3)
Toupet	3(4.8)
未做折叠	3(4.8)
手术时间(min,±s)	114.5±35.7
裂孔大小(cm,±s)	4.3±1.7
裂孔≥4 cm[例(%)]	49(79.0)
膈肌脚缝合针数(±s)	4.0±1.7
折叠袢缝合针数(±s)	2.8±1.3
术后住院时间[M(IQR)]	5.0(4.0, 6.0)
术中及短期并发症[例(%)]
胸膜损伤	18(29.0)
出血二次手术后死亡	1(1.6)
胸腔积液穿刺	1(1.6)
30天内再入院	1(1.6)

变量	复发			吞咽困难
变量	OR	95% CI	P值	OR	95% CI	P值
体重指数	0.937	0.736~1.192	0.595	0.981	0.815~1.180	0.835
年龄	1.009	0.946~1.076	0.792	0.954	0.909~1.001	0.053
食管裂孔大小	0.491	0.151~1.593	0.236	1.114	0.559~2.221	0.760
原发/复发	5.222	0.906~30.112	0.064	1.050	0.193~5.725	0.955
膈肌脚缝合针数	0.462	0.208~1.027	0.058	1.039	0.598~1.807	0.891

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