360° laparoscopic fundoplication with tension-free hiatoplasty in the treatment of symptomatic gastroesophageal reflux disease

Basso, Nicola; Leo, A. De; Genco, Alfredo; Rosato, P.; Rea, Sabrina; Spaziani, Erasmo; Primavera, A.

doi:10.1007/s004649900092

Cited by 96 publications

(61 citation statements)

References 19 publications

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“…16,24 We and others advocate the use of mesh reinforcement of hiatal hernia repair in order to decrease the hernia recurrence. 13,17,[36][37][38] The efficacy of PTFE reinforcement in hiatal herniorraphy has been demonstrated in a randomized trial. 13 Our current indication for mesh utilization is a hiatal defect greater than 5 cm.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Frantzides

Madan

Carlson

et al. 2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Objective: The aim of this study was to evaluate the mechanisms of failure after laparoscopic fundoplication and the results of revision laparoscopic fundoplication. Background: Laparoscopic Nissen fundoplication has become the most commonly performed antireflux procedure for the treatment of gastroesophageal reflux disease, with success rates from 90 to 95%. Persistent or new symptoms often warrant endoscopic and radiographic studies to find the cause of surgical failure. In experienced hands, reoperative antireflux surgery can be done laparoscopically. We performed a retrospective analysis of all laparoscopic revision of failed fundoplications done by the principle author and the respective fellow within the laparoscopic fellowship from 1992 to 2006. Methods: A review was performed on patients who underwent laparoscopic revision of a failed primary laparoscopic fundoplication. Results: Laparoscopic revision of failed fundoplication was performed on 68 patients between 1992 and 2006. The success rate of the laparoscopic redo Nissen fundoplication was 86%. Symptoms prior to the revision procedure included heartburn (69%), dysphagia (8.8%), or both (11.7%). Preoperative evaluation revealed esophagitis in 41%, hiatal hernia with esophagitis in 36%, hiatal hernia without esophagitis in 7.3%, stenosis in 11.74%, and dysmotility in 2.4%. The main laparoscopic revisions included fundoplication alone (41%) or fundoplication with hiatal hernia repair (50%). Four gastric perforations occurred; these were repaired primarily without further incident. An open conversion was performed in 1 patient. Length of stay was 2.5 Ϯ 1.0 days. Mean follow-up was 22 months (range, 6-42), during which failure of the redo procedure was noted in 9 patients (13.23%). Conclusion: Laparoscopic redo antireflux surgery, performed in a laparoscopic fellowship program, produces excellent results that approach the success rates of primary operations. 135

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Frantzides

Madan

Carlson

et al. 2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…The largest prospective series reporting on PP application demon- [4] 2000 NR 70 GERD and/or hiatal hernia Kamolz et al [5] 2002 Prospective 100 NR Granderath et al [6] 2002 NR 170 GERD symptomatology, LESP <6 mmHg Frantzides et al [7] 2002 Prospective 36 Hiatal defect >8 cm Champion and Rock [8] 2003 Retrospective 52 GERD symptomatology, hiatal defect >5 cm Casaccia et al [9] 2005 Retrospective 27 Paraesophageal hernia Granderath et al [10] 2005 Prospective 50 GERD Gryska et al [11] 2005 NR 135 GERD symptomatology, paraesophageal hernia, hernia recurrence Oelschlager et al [12] 2006 Prospective 51 Symptomatic paraesophageal hernia…”

Section: Mesh Materialsmentioning

confidence: 99%

Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence

Antoniou

Koch

Antoniou

et al. 2011

Langenbecks Arch Surg

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“…The most commonly used mesh is polypropylene (Prolene; Ethicon, Inc., Somerville, NJ, USA) [11][12][13]. Several different types of polytetrafl uroethylene (PTFE) and composite materials have been used including dual mesh (W.L Gore and associates, Inc., Flagstaff, AZ, USA) [14] and a simple PTFE patch [15,16].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of large hiatus hernia with mesh cruroplasty

Chowbey

Mittal²,

Dey³

et al. 2008

Indian J Surg

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Purpose Laparoscopy has become the standard surgical approach to surgery for gastrooesophageal refl ux disease (GERD) and hiatal hernia repair with excellent long-term results and high patient satisfaction. However several studies have shown that hiatal hernia repair, especially large hiatus are associated with high recurrence rate. Mesh reinforcement has been proposed for repair of large hiatus hernia. The objective of this study was to evaluate the role of mesh cruroplasty in management of large hiatus hernia (> 5 cm).Methods Between February 2002 to December 2007, 73 patients (28 men and 45 women) who underwent laparoscopic hiatal hernia repair with mesh cruroplasty were included in our study. Mesh reinforcement (cruroplasty) was used for repair of large hiatus hernia (>5 cms hernial defect). Mean age was 50.4 years (range 30-72 years). Follow up included barium swallow of patients at 3 months and yearly thereafter.Results Seventy-three patients underwent mesh cruroplasty for large hiatus hernia. We were able to adequately mobilise the oesophagus to achieve an intra-abdominal length of at least 3 cm in all patients. Intraoperative complication rate was 8.21% (6/73), intraoperative complications included pleural tear, bleeding from splenic capsule laceration and short gastric vessels. Postoperative complication rate was 4.1% (3/73), which included complete dyspahgia, atelactasis and pneumonia. Mean duration of hospitalisation was 3.5 days (range 3-9 days). Five patients (5/73) were lost to follow up. Four patients (5.8%) developed recurrence on routine follow up. No mesh related complications were noted on long-term follow up period. Mean follow up period was 3.2 years (range 5 months-6 years). ConclusionOur data supports the use of mesh in hiatal hernia repair, especially in large hiatus hernia as it leads to low recurrence rates. Longer follow up and more randomised controlled trials are needed to establish laparoscopic mesh cruroplasty as standard technique for large hiatal hernia repair.

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360° laparoscopic fundoplication with tension-free hiatoplasty in the treatment of symptomatic gastroesophageal reflux disease

Abstract: This tension-free hiatoplasty seems to be an effective solution to prevent postoperative paraesophageal hernia in patients undergoing antireflux laparoscopic surgery. However, longer follow-up is still needed.

Cited by 96 publications

References 19 publications

Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence

Laparoscopic management of large hiatus hernia with mesh cruroplasty

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