Obesity is an independent risk factor of gastroesophageal reflux disease, which is usually related to the existence of esophageal hiatal hernia.Similarly, hiatal hernia is an independent risk factor of gastroesophageal reflux disease, which is prevalent in about 40% of obese patients.Although laparoscopic sleeve gastrectomy is becoming more and more popular in weight-loss surgery, and it is safe and effective, it may be accompanied by symptoms of gastroesophageal reflux disease and the need for esophageal hiatal hernia repair.In addition, the effect of laparoscopic sleeve gastrectomy combined with hiatus hernia repair on the symptoms of gastroesophageal reflux disease is controversial and the efficacy is not clear.Therefore, this article mainly reviews the influence of laparoscopic sleeve gastrectomy combined with hiatus hernia repair on obesity with gastroesophageal reflux disease and the existing problems.

Objective:To investigate the clinical efficacy of femoral hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 102 patients with femoral hernia who were admitted to People′s Hospital of Xinjiang Uygur Autonomous Region from January 2012 to January 2019 were collected. There were 13 males and 89 females, aged (65±9)years, with a range from 31 to 91 years. Patients underwent emergency or selective surgery according to Guideline for diagnosis and treatment of adult inguinal hernia (2018 edition), including laparoscopic transabdominal preperitoneal hernia repair (TAPP), McVay repair or open preperitoneal mesh hernioplasty. Observation indicators: (1) intraoperative and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect complications and hernia recurrence up to February 2019. Measurement data with normal distribution were represented as Mean± SD, and count data were represented as absolute numbers. Results:(1) Intraoperative and postoperative situations: 102 patients had unilateral femoral hernia, including 57 of left hernia and 45 of right hernia. There were 79 patients with incanceration or strangulation, and 23 without incanceration or strangulation. The 79 patients with incancerated or strangulated hernia underwent emergency surgery, including 35 undergoing open McVay repair (5 had conversion from laparoscopic surgery) and 44 undergoing laparoscopic TAPP. The 23 patients without incanceration or strangulation underwent selective surgery, including 3 undergoing open preperitoneal mesh hernioplasty and 20 undergoing laparoscopic TAPP. Meshes were used on 87 of the 102 patients. The operation time, time to postoperative drainage tube removal, and duration of postoperative hospital stay were (62±3)minutes, (2.2±0.3)days, and (3.5±1.3)days, respectively. (2) Follow-up: 102 patients were followed up for (7±3)months, with a range from 1 to 12 months. During the follow-up, pulmonary infection, deep venous thrombosis, incisional infection, intestinal obstruction, seroma, intestinal fistula, and affected hernia recurrence were observed in 5, 4, 3, 3, 1, 1, and 1 of the 79 patients undergoing emergency surgery, respectively. There were 3 patients dead. One patient with intestinal obstruction underwent secondary enterostomy and then closure at postoperative 3 months. The other patients with complications were improved after symptomatic and supportive treatment. During the follow-up, seroma, intestinal fistula, and affected hernia recurrence were observed in 1, 1, and 1 of the 23 patients with selective surgery. The above patients with complications were improved after symptomatic and supportive treatment.Conclusion:Early and correct diagnosis, selection of appropriate surgical methods, and immediate surgery can effectively treat femoral hernia.