Laparoscopic Repair of Paraesophageal Hernia

Dallemagne, Bernard; Kohnen, Laurent; Perretta, Silvana; Weerts, J; Markiewicz, S; Jehaes, C

doi:10.1097/sla.0b013e3181ff44c0

Cited by 193 publications

(58 citation statements)

References 36 publications

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“…Review of references for additional manuscripts was performed. Thirteen publications meeting inclusion criteria were identified: 3 randomized controlled trials(2, 3, 5) and 10 observational studies (4 prospective;(15–18) 4 retrospective;(19–22) and 2 with design not specified. (23, 24) Study quality using the GRADE Working Group approach was performed (Table 1).…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair

Tam

Winger

Nason

2016

The American Journal of Surgery

144

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Structured Abstract Background Equipoise exists regarding whether mesh cruroplasty during laparoscopic large hiatal hernia repair improves symptomatic outcomes compared to suture repair. Data Source Systematic literature review (MEDLINE and EMBASE) identified 13 studies (1194 patients; 521 suture and 673 mesh) comparing mesh versus suture cruroplasty during laparoscopic repair of large hiatal hernia. We abstracted data regarding symptom assessment, objective recurrence, and reoperation and performed meta-analysis. Conclusions The majority of studies reported significant symptom improvement. Data were insufficient to evaluate symptomatic versus asymptomatic recurrence. Time to evaluation was skewed toward longer follow-up after suture cruroplasty. Odds of recurrence (OR 0.51, 95% CI 0.30–0.87; overall p=0.014) but not need for reoperation (OR 0.42, 95% CI 0.13–1.37; overall p=0.149) were less after mesh cruroplasty. Quality of evidence supporting routine use of mesh cruroplasty is low. Mesh should be used at surgeon discretion until additional studies evaluating symptomatic outcomes, quality of life and long-term recurrence are available.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair

Tam

Winger

Nason

2016

The American Journal of Surgery

144

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“…The reported rate of delayed gastric emptying following primary laparoscopic repair of paraoesophageal hernias of any size is 0–3 per cent7, 8, 9. This rate increases with the number of revisional surgery procedures to as high as 75 per cent17.…”

Section: Discussionmentioning

confidence: 99%

“…With continued improvement in laparoscopic technology and techniques, this approach has been increasingly applied to repair very large hiatus hernias4 5. Despite variable rates of hernia recurrence5, 6, 7, the outcomes of surgery are generally encouraging, with substantial symptomatic relief of reflux and low associated operative mortality or morbidity8 9. Most follow‐up studies have focused on minimizing hernia recurrence and its associated symptomatology6 7.…”

Section: Introductionmentioning

confidence: 99%

“…Despite variable rates of hernia recurrence5, 6, 7, the outcomes of surgery are generally encouraging, with substantial symptomatic relief of reflux and low associated operative mortality or morbidity8 9. Most follow‐up studies have focused on minimizing hernia recurrence and its associated symptomatology6 7. In contrast, little is known about delayed gastric emptying following laparoscopic repair of very large hiatus hernias.…”

Section: Introductionmentioning

confidence: 99%

“…This in turn may relate to the extent of surgical dissection near the hiatus17. Despite a relatively low rate of delayed gastric emptying reported for repair of small hiatus hernias7, 8, 9, its incidence and predisposing factors after surgery for very large hiatus hernias remain unknown. This study sought to identify the incidence of delayed gastric emptying following surgery for very large hiatus hernias, highlight risk factors for its occurrence and examine its medium‐term impact on patients, based on data collected from a prospective randomized trial.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

et al. 2017

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BackgroundDelayed gastric emptying can complicate surgery for hiatus hernia. The aim of this study was to quantify its incidence following laparoscopic repair of very large hiatus hernias, identify key risk factors for its occurrence and determine its impact on clinical outcomes.MethodsData collected from a randomized trial of patients who underwent laparoscopic mesh versus sutured repair of very large hiatus hernias (more than 50 per cent of stomach in chest) were analysed retrospectively. Delayed gastric emptying was defined as endoscopic evidence of solid food in the stomach after fasting for 6 h at 6 months after surgery.ResultsDelayed gastric emptying occurred in 19 of 102 patients (18·6 per cent). In univariable analysis, type 2 paraoesophageal hernia (relative risk (RR) 3·15, 95 per cent c.i. 1·41 to 7·06), concurrent anterior and posterior hiatal repair (RR 2·66, 1·14 to 6·18), hernia sac excision (RR 4·85, 1·65 to 14·24), 270°/360° fundoplication (RR 3·64, 1·72 to 7·68), division of short gastric vessels (RR 6·82, 2·12 to 21·90) and revisional surgery (RR 3·69, 1·73 to 7·87) correlated with delayed gastric emptying. In multivariable analysis, division of short gastric vessels (RR 6·27, 1·85 to 21·26) and revisional surgery (RR 6·19, 1·32 to 28·96) were independently associated with delayed gastric emptying. Delayed gastric emptying correlated with adverse gastrointestinal symptomatology, including higher rates of bloating, nausea, vomiting and anorexia, as well as reduced patient satisfaction with the operation and recovery.ConclusionDelayed gastric emptying following large hiatus hernia repair is common and associated with adverse symptoms and reduced patient satisfaction. Division of short gastric vessels and revisional surgery were independently associated with its occurrence.

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Long-term Quality of Life and Risk Factors for Recurrence After Laparoscopic Repair of Paraesophageal Hernia

et al. 2015

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Laparoscopic Repair of Paraesophageal Hernia

Cited by 193 publications

References 36 publications

A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair

A systematic review and meta-analysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

Long-term Quality of Life and Risk Factors for Recurrence After Laparoscopic Repair of Paraesophageal Hernia

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