Laparoscopic repair for giant hiatal hernia：A clinical analysis of 75 patients        SUN Xiang-yu, QIN Ming-fang, ZHAO Hong-zhi, et al. Department of Mini-invasive Surgery, Tianjin Nankai Hospital, Tianjin 300100, China
Corresponding author: SUN Xiang-yu, E-mail: xiangyusun79@126.com
Abstract    Objective    To investigate the safety and effectiveness of laparoscopic repair for giant hiatal hernia. Methods    The clinical data of 75 patients with giant hiatal hernia performed laparoscopic repair between January 2006 and August 2012 in Tianjin Nankai Hospital were analyzed retrospectively. The operation time, hospitalization time, intraoperative and postoperative complications, postoperative improvement of symptoms and upper gastrointestinal imaging were studied. Results    All the patients were treated by laparoscopy successfully. Fifty-one patients were reinforced with meshes. Twenty-four patients were reinforced without mesh. Hiatal pillars in 40 patients were partly contracted and closed with meshes. Hiatal pillars in 35 patients were directly closed up to normal diameter by interrupted stitches. Among them, 11 patients were placed with meshes. Laparoscopic repair complicated with fundoplication was performed in 64 patients with average operation time of (97.2±2.1)min, average operative blood loss of (82.0±1.7)mL and average hospital stay of (5.0±1.2)d. No conversion and death occurred. Seventeen patients (22.7%) had short-term or long-term complications. Seventy-five patients were followed up for 3 months to 62 months with average of (31.0±2.1)months. Main symptoms of 66 patients (88%) were disappeared. Nine patients （12%）had recurrence of symptoms. Four patients（5.3%）were found recurrence by barium swallow. Conclusion    Laparoscopic repair for giant hiatal hernia is safe and reliable. Mesh repair can reduce the recurrence rate but accompanied with risk of complication.