Background: Esophageal hiatal hernia can be classified into four types. It has been reported that most complications occurred in type II-IV hernia patients compared with type I hernia. This study aimed to investigate and compare the efficacy, complications, and long-time outcomes after laparoscopic fundoplication between type I and type II-IV hernia patients. Materials and Methods: Medical records of 110 children who underwent laparoscopic fundoplication during 2008-2017 in our institution were retrospectively analyzed. Information of postoperative symptoms, complications, and quality of life (QOL) were compared between different types. Results: All 110 children underwent laparoscopic fundoplication, and none converted to open surgery. Type I and type II-IV each accounted for 50.9% and 42.8%. There was no significant difference in the perioperative data between type I and type II-IV esophageal hiatal hernia. The follow-up information of 81 children was obtained. The scores of postoperative symptoms were comparable between type I and type II-IV group, except the severity score of reflux symptom was higher in type I hernia patients (P = .032). The difference in the incidence of postoperative complications and recurrence after laparoscopic fundoplication between type I and type II-IV hernia was not significant. The QOL in three aspects improved significantly after laparoscopic fundoplication in all types of esophageal hiatal hernia. Conclusions: Laparoscopic fundoplication was an effective approach for all types of esophageal hiatal hernia. Type II-IV hernia could obtain a comparable therapeutic effect and long-time outcome compared with type I hernia despite its increased complexity of the anatomy and the required laparoscopic repair procedure.
Keywords: esophageal hiatal hernia; follow-up; fundoplication; laparoscopy.