Combined paraesophageal hernia repair and partial longitudinal gastrectomy in obese patients with symptomatic paraesophageal hernias

Rodriguez, John; Kroh, Matthew; El‐Hayek, Kevin; Timratana, Poochong; Chand, Bipan

doi:10.1007/s00464-012-2347-8

Cited by 27 publications

(15 citation statements)

References 23 publications

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“…Symptom relief was reported by most of our patients in the follow-up survey. Outcomes from the initial short-term study by Rodriguez et al 18 showed a significant symptomatic response, in addition to a considerable weight loss. Upon follow-up analysis, we observed a plateau and possible shift toward symptom recurrence, as well as a softening of the weight loss curve.…”

Section: Discussionmentioning

confidence: 95%

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Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

Davis

Rodriguez

El‐Hayek

et al. 2015

JSLS

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Background and Objectives:Treatment of gastroesophageal reflux disease (GERD) with hiatal hernia in obese patients has proven difficult, as studies demonstrate poor symptom control and high failure rates in this patient population. Recent data have shown that incorporating weight loss procedures into the treatment of reflux may improve overall outcomes.Methods:We retrospectively reviewed 28 obese and morbidly obese patients who presented from December 2007 through July 2013 with large or recurrent type 3 or 4 paraesophageal hernia. All of the patients underwent combined paraesophageal hernia repair and partial longitudinal gastrectomy. Charts were retrospectively reviewed, and the patients were contacted to determine symptomatic relief.Results:Mean preoperative body mass index was 38.1 ± 4.9 kg/m2. Anatomic failure of prior fundoplication occurred in 7 patients (25%). The remaining 21 had primary paraesophageal hernia, 3 of which were type 4. Postoperative complications included pulmonary embolism (n = 1), pulmonary decompensation (n = 2), and wound infection (n = 1). Mean hospital stay was 5 ± 3 days. Upper gastrointestinal esophagogram was performed in 21 patients with no immediate recurrence or staple line dehiscence. Mean excess weight loss was 44 ± 25%. All of the patients surveyed experienced near to total resolution of their preoperative symptoms within the first month. At 1 year, symptom scores decreased significantly. At 27 months, however, there was a mild increase in the scores. Return of severe symptoms occurred in 2 patients, both of whom underwent conversion to gastric bypass.Conclusions:Combined laparoscopic paraesophageal hernia repair with longitudinal partial gastrectomy offers a safe, feasible approach to the management of large or recurrent paraesophageal hernia in well-selected obese and morbidly obese patients. Short-term results were promising; however, intermediate results showed increasing rates of reflux symptoms that required medical therapy or conversion to gastric bypass.

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Section: Discussionmentioning

confidence: 95%

“…This study was a retrospective analysis of a prospectively maintained database of patients with a BMI greater than 30 kg/m 2 and symptomatic type III or IV paraesophageal hernia. The study is a follow-up of a short-term series 18 involving 19 patients. These patients were contacted for updated data, and 9 new patients were added.…”

Section: Methodsmentioning

confidence: 99%

Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

Davis

Rodriguez

El‐Hayek

et al. 2015

JSLS

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“…12 Nineteen patients were studied, with a mean preoperative BMI of 37.8 kg/m 2 . Mesh was used to reinforce the hiatus in 15 of 19 cases.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic Bioabsorbable Mesh for Hiatal Hernia Repair During Sleeve Gastrectomy

Clapp¹

2013

JSLS

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“…12 The approach to PEH in morbidly obese patients remain a therapeutic challenge. Despite increasing data, the ideal surgical procedure that addresses both obesity and PEH has not been well established, [13][14][15] and randomized controlled trials are lacking.…”

Section: Patient's Selection For Surgery and Preoperative Work-upmentioning

confidence: 99%

Laparoscopic Paraesophageal Hernia Repair

Allaix¹,

Patti²

2013

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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The last 2 decades have witnessed a revolution in the treatment of patients with paraesophageal hernia (PEH). Nowadays, the laparoscopic repair with fundoplication is considered as the primary treatment modality in most academic centers for symptomatic patients. Three findings have clearly emerged: (1) this procedure is technically demanding; (2) it is associated with relief of symptoms in most patients; and (3) most recurrences are small and asymptomatic. This article describes our approach step-by-step to the repair of a paraesophageal hiatal hernia, focusing on several technical controversies.

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Combined paraesophageal hernia repair and partial longitudinal gastrectomy in obese patients with symptomatic paraesophageal hernias

Cited by 27 publications

References 23 publications

Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

Paraesophageal Hernia Repair With Partial Longitudinal Gastrectomy in Obese Patients

Prosthetic Bioabsorbable Mesh for Hiatal Hernia Repair During Sleeve Gastrectomy

Laparoscopic Paraesophageal Hernia Repair

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