An Operation for Hiatus Hernia with Short Oesophagus

Collis, J. Leigh

doi:10.1136/thx.12.3.181

Cited by 109 publications

(71 citation statements)

References 2 publications

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“…2 Recurrence of hiatus hernia following surgery has been a consistent problem in many reports and has led to varied techniques of repair including the Collis gastroplasty, mesh hiatal repair and gastropexy procedures. 7,9,27 The overall *Denominator is the number of patients eligible for testing given that they had reached the respective follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Durability of giant hiatus hernia repair in 455 patients over 20 years

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Furtado

Hayward

et al. 2015

annals

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INTRODUCTION The surgical management of symptomatic giant hiatus hernia (GHH) aims to improve quality of life (QoL) and reduce the risk of life threatening complications. Previous reports are predominantly those with small sample sizes and short follow-up periods. The present study sought to assess a large cohort of patients for recurrence and QoL over a longer time period. METHODS This was a follow-up study of a prospectively collected database of 455 consecutive patients. Primary repair of GHH was evaluated by endoscopy/barium meal for recurrence and a standardised symptom questionnaire for QoL. Recurrence was assessed for size, elapsed time, oesophagitis and symptoms. RESULTS Objective and subjective review was achieved in 91.9% and 68.6% of patients. The median age was 69 years (range: 15-93 years) and 64% were female. Laparoscopic repair was completed in 95% (mesh in 6% and Collis gastroplasty in 7%). The 30-day mortality rate was 0.9%. The proportion of patients alive at five and ten years were 90% and 75% respectively. Postoperative QoL scores improved from a mean of 95 to 111 (p<0.01) and were stable over time (112 at 10 years).The overall recurrence rate was 35.6% (149/418) at 42 months; this was 11.5% (48/418) for hernias >2cm and 24.2% (101/418) for <2cm. The rate of new recurrence at 0-1 years was 13.7% (>2cm = 3.4%, <2cm = 10.3%), at 1-5 years it was 30.8% (>2cm = 9.5%, <2cm = 21.3%), at 5-10 years it was 40.1% (>2cm = 13.8%, <2cm = 26.3%) and at over 10 years it was 50.0% (>2cm = 25.0%, <2cm = 25.0%). Recurrence was associated with oesophagitis but not decreased QoL. Revision surgery was required in 4.8% of cases (14.8% with recurrence). There were no interval major GHH complications. CONCLUSIONS Surgery has provided sustained QoL improvements irrespective of recurrence. Recurrence occurred progressively over ten years and may predispose to oesophagitis.

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Section: Discussionmentioning

confidence: 99%

“…These techniques have included mesh hiatal repair 7 and Collis gastroplasty. 8,9 Reported recurrence rates have been variable and depend on the definition used 5,6 with some series excluding recurrence less than 2cm. 5,7,10 QoL has been shown to be improved following repair.…”

mentioning

confidence: 99%

Durability of giant hiatus hernia repair in 455 patients over 20 years

Page

Furtado

Hayward

et al. 2015

annals

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“…[1][2][3][4][5][6][7] The result of this interest has been the generation of a wealth of data regarding its pathophysiology and treatment. There is, however, a striking paucity of reference to the short esophagus in the current laparoscopic literature.…”

Section: Discussionmentioning

confidence: 99%

The Short Esophagus: Pathophysiology, Incidence, Presentation, and Treatment in the Era of Laparoscopic Antireflux Surgery

Horvath¹,

Swanström²,

Jobe³

2000

Annals of Surgery

177

127

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“…However, complications are observed with this procedure, even when treating non-neuropathic children. 5 Collis (1957) 11 described a gastroplasty technique for lengthening the esophagus in patients with hiatal hernia and short esophagus. This concept gained wide acceptance and was much utilized at that time, before it was understood that progressive shortening of the esophagus secondary to esophagitis can occur.…”

Section: Introductionmentioning

confidence: 99%

Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy

2007

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RESULTS:The mean follow-up was 5.2 months; symptoms were reduced by 42.8% (NF) (p = 0.001) and 57.1% (VGP) (p = 0.006). The Boix-Ochoa score was favorable for both groups: NF (p < 0.001) and VGP (p < 0.042). The overall mortality was 14.28% in both groups and was due to causes unrelated to the surgical treatment. CONCLUSION:The two operative procedures were shown to be effi cient and effi cacious for the treatment of GERD in neuropathic patients, over the study period.

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An Operation for Hiatus Hernia with Short Oesophagus

Cited by 109 publications

References 2 publications

Durability of giant hiatus hernia repair in 455 patients over 20 years

Durability of giant hiatus hernia repair in 455 patients over 20 years

The Short Esophagus: Pathophysiology, Incidence, Presentation, and Treatment in the Era of Laparoscopic Antireflux Surgery

Vertical gastric plication versus Nissen fundoplication in the treatment of gastroesophageal reflux in children with cerebral palsy

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