Critical appraisal of the impact of surgical repair of type II–IV paraoesophageal hernia (POH) on pulmonary improvement: A systematic review and meta-analysis

Publication date: Available online 8 February 2020Source: The SurgeonAuthor(s): Sivesh K. Kamarajah, Charlie Boyle, Maziar Navidi, Alexander W. PhillipsAbstractBackgroundParaoesophageal hernia (POH) comprising type II–IV hiatal hernia often presents with pulmonary symptoms such as shortness of breath. However, impact of surgical repair on improvement in pulmonary symptoms is unclear.ObjectiveThis systematic review and meta-analysis aimed at characterising impact of POH repair on patient reported improvement in pulmonary symptoms.MethodsThis systematic review identified studies reported pulmonary symptoms in patients with undergoing surgical repair for Type II–IV POH from 1st January 2001 to 1st December 2018. Primary outcome was improvement in pulmonary symptoms. Secondary outcomes were improvement in other patient-reported outcomes such as heartburn, regurgitation, chest pain, and dysphagia and intraoperative and postoperative outcomes.ResultsThis systematic review identified 27 studies (n = 4428 patients) reporting assessment of pulmonary symptoms. However, only 21 studies (n = 2902 patients) reported preoperative and postoperative pulmonary symptoms and hence these were included in the final meta-analysis. There was significant improvement in pulmonary symptoms following POH repair (OR: 8.40, CI95%: 4.91–14.35, p 
Source: The Surgeon - Category: Surgery Source Type: research

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Source: Photochemistry and Photobiology - Category: Science Authors: Tags: RESEARCH ARTICLE Source Type: research
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Source: Biomedica : Revista del Instituto Nacional de Salud - Category: International Medicine & Public Health Tags: Biomedica Source Type: research
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Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
A unique case of intractable hiccups. Patient is 48 years old with severe hiccups followed by burping which relieves his chest pain, nausea and vomiting, and severe heartburn and reflux. He has a remote history of Nissen fundoplication that was revised into a roux en y gastric bypass. He also had a prior hiatal hernia repair. This over time yielded weight loss and resolution of symptoms. The then had the above symptoms start with findings as described by the video presentation.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Conclusion: OPRBS in hiatal hernia repair have been associated with excellent early patient outcomes in this study. OPRBS represent a new paradigm in hernia repair, as it is the first clinically available biological repair material reinforced with embroidered resorbable or permanent synthetic polymer. Relative weaknesses of the current study include the small sample size (n = 25), and short-term (mean = 14.2 months) followup. Long-term followup and additional studies will be required to confirm these findings. PMID: 30607101 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
ConclusionsUse of non-absorbable mesh to reinforce primary hiatal hernia repair results in equal hiatal hernia recurrence and symptomatic outcome compared to repair using sutures alone. During 1-year follow-up, there were no mesh-related complications. Follow-up beyond 1  year needs to demonstrate whether these findings are sustained.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusions Selective mesh cruroplasty was not associated with differences in symptom outcomes or radiographic recurrence rates during laparoscopic PEH repair. Radiographic recurrence was associated with dissatisfaction, emphasizing the need for continued focus on reducing recurrences.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Conclusions Selective mesh cruroplasty was not associated with differences in symptom outcomes or radiographic recurrence rates during laparoscopic PEH repair. Radiographic recurrence was associated with dissatisfaction, emphasizing the need for continued focus on reducing recurrences. Summary for Table of Contents There is equipoise regarding the routine use of mesh for crural reinforcement during laparoscopic paraesophageal hernia repair. Selective use of mesh in nearly 800 patients was associated with similar rates of symptom resolution and hernia recurrence. Hernia recurrence was associated with patient dissatisfaction...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
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Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
Abstract BACKGROUND: Laparoscopic sleeve gastrectomy has become a popular bariatric surgery in recent years. However, it has been linked to worsening or newly developed gastroesophageal reflux disease (GERD) in the postoperative period. OBJECTIVES: The purpose of this study is to determine the safety and effectiveness of anterior fundoplication sleeve gastrectomy in patients with reflux. SETTING: Academic hospital, United States. METHODS: We prospectively collected data on 31 sleeve gastrectomy patients who concurrently underwent anterior fundoplication between July 2014 and March 2016. Patients wer...
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
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