Short-Term and Long-Term Outcomes of Paraesophageal Hernia Repair

The assessment of outcome after paraesophageal repair is difficult and complex. There is a wide range of reported outcomes that are not consistently defined. The focus of this article is on short-term ( ≤5 years) and long-term (>5  year) outcomes after laparoscopic paraesophageal repair and reviews key patient-reported outcomes (gastroesophageal reflux disease [GERD]–related and non–GERD-related symptoms), radiologic recurrence, additional therapy, and objective measurements. Overall, patients reported an excellent impro vement in their quality of life after repair that remains durable. Recurrences are lower when axial and radial tension is addressed. Reoperative surgery is infrequent.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research

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This study examined outcomes, surgical complications, and revisions in patients treated with laparoscopic Nissen fundoplication for hiatal hernia and substantial gastroesophageal reflux disease. In total, 85 consecutive patients who underwent hernia repair with MIROMESH Biologic Matrix, a novel hepatic-derived surgical mesh served as subjects. Subjects were contacted by phone, consented, and participated in an Institutional Review Board-approved structured phone interview. Responses were acquired from 73 of the 85 patients. The gastroesophageal reflux disease health–related quality of life showed significant improvem...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
This study evaluates the effect of HHR using a standardized technique for cruroplasty with a reinforcing polyglycolic acid and trimethylene carbonate mesh (PGA/TMC) on patient symptoms and outcomes. A retrospective review of patient perioperative characteristics and postoperative outcomes was conducted for cases of laparoscopic hiatal hernia repair (LHHR) using a PGA/TMC mesh performed over 21 months. Gastroesophageal reflux disease symptom questionnaire responses were compared between preoperative and three postoperative time points. Ninety-six patients underwent LHHR with a PGA/TMC mesh. Postoperatively, the number of ov...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10% and 20% in Western populations with an even higher incidence in populations with obesity [1]. The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone laparoscopic Roux-en-Y gastric bypass (LRYGB). De Goot et  al. [2], in their 2009 meta-analysis, demonstrated improvement in GERD in people with obesity after LRYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Video case report Source Type: research
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10 to 20% in western populations with an even higher incidence in populations with obesity (1). The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone Laparoscopic Roux En Y Gastric Bypass (LRYGB). De Goot et al in their 2009 meta-analysis demonstrated improvement in GERD in people with obesity following LRYGB(2).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study describes changes in GERD symptoms in patients undergoing LSG and HHR.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study was undertaken to evaluate the robotic approach versus laparoendoscopic single-site (LESS) approach for redo fundoplications. With an Institutional Review Board approval, 64 patients undergoing LESS (n = 32) or robotic (n = 32) redo antireflux operations were prospectively followed up. Data are presented as median (mean + SD). For LESS versus robotic redo operations, the operative duration was 145 (143 ± 33.5) versus 196 (208 ± 76.7) minutes (P
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months. Results. Ninety-nine patients were enrolled, and all w...
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
Conclusion: The laparoendoscopic technique of hiatal hernia repair, using extracorporeal arthroscopic sliding knots and concomitant transoral incisionless fundoplication, is safe, preserves an ALHA, and allows proper surgical techniques in a confined operative field. PMID: 30996584 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
Conclusion: In this series of 32 cases, laparoscopic cruroplasty with UBM graft reinforcement has been effective and durable at 12 months of followup. This technique may offer one satisfactory solution for large hiatal hernia repair concomitant with laparoscopic sleeve gastrectomy that may achieve a durable repair with low GERD symptoms. PMID: 30880900 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
Day-case surgery (DCS) is a hot topic in gastrointestinal surgery. DCS was primarily validated for inguinal hernia repair, cholecystectomy [1] and the treatment of gastroesophageal reflux disease [2, 3]. New indications for DCS in the field of gastrointestinal surgery have been recently described, such as laparoscopic sleeve gastrectomy (SG) [4], ileostomy closure [5], colectomy [6] and liver resection [7].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original Articles Source Type: research
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