Long-term outcome of laparoscopic repair of paraesophageal hernia

Mattar, Samer G.; Bowers, Steven P.; Galloway, Kathy; Hunter, John G.; Smith, C. Daniel

doi:10.1007/s00464-001-8194-7

Cited by 189 publications

(111 citation statements)

References 12 publications

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“…Although it is known that anatomical recurrences can occur in up to 42% of laparoscopically repaired HH cases, these patients are rarely symptomatic and very few require repeat surgery. (36,37) There were no patients with symptomatic recurrence in our study.…”

Section: Discussionmentioning

confidence: 61%

Para-oesophageal and parahiatal hernias in an Asian acute care tertiary hospital: an underappreciated surgical condition

Koh

Ong

June

et al. 2016

smedj

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Section: Discussionmentioning

confidence: 61%

Para-oesophageal and parahiatal hernias in an Asian acute care tertiary hospital: an underappreciated surgical condition

Koh

Ong

June

et al. 2016

smedj

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“…Initially, laparoscopy was not indicated in these cases, because higher rates of relapse were observed, when compared to patients treated by open surgery 5,10,11,13,14,18,19 . Hashemi et al 10 , did a retrospective study comparing the long-term outcome of 54 patients with large paraesophageal hernias operated by open techniques (thoracotomy or laparotomy) and laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

Tela de polipropileno no reparo laparoscópico de grandes hérnias hiatais: aspectos técnicos

Brandalise¹,

Aranha²,

Brandalise³

2012

ABCD, arq. bras. cir. dig.

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-Background -The minimally invasive surgery has gained rapidly important role in the treatment of gastroesophageal reflux disease. However, the best method to treat large paraesophageal hernias (type III and IV) is still under discussion. The use of prosthetics for enhancing the crural repair has been proposed by several authors in order to reduce the high relapse rates found in these patients. Aim -To demonstrate the technique and surgical results in using an idealized polypropylene mesh for the strengthening of the cruroraphy in large hiatal hernias. Methods -Was applied the polypropylene mesh to reinforce the hiatal closure in large hernias -types II to IV in Hill's classification -with a primary or recurrent hiatal defect greater than 5 cm, in a series of 70 patients. The prosthesis was done cutting a polypropylene mesh in a U-shape, adapted to the dimensions found in the intraoperative field and coating the inner edge (which will have direct contact with the esophagus) with a silicon catheter. This was achieved by removing a small longitudinal segment of the catheter and then inserting the edge of the cut mesh, fixing with running nylon 5-0 suture. Results -From 1999 to 2012, this technique was used in 70 patients. There were 52 females and 18 males, aged 32-83 years (mean 63 years). In 48 (68.6%) patients, paraesophageal hernia was primary and in 22 (31.4%), it was relapse after antireflux surgery. The only case of death in this series (1.4%) occurred on 22nd postoperative day in one patient (74 y) that had a laceration of the sutures on the fundoplication, causing gastropleural fistula and death. There was no relationship with the use of the prosthesis.A follow-up of six months or more was achieved in 60 patients (85.7%), ranging from six to 146 months (mean 49 months). All patients have at least one follow-up endoscopy or esophageal contrast examination, and a clinical interview. In this follow-up period, no cases of complications related to the prosthesis (stenosis or erosion) were observed. Conclusion-The use of this model of polypropylene mesh is safe if the technical aspects of its placement are followed carefully. ABCDDV/874RESUMO -Racional: A cirurgia minimamente invasiva ganhou rapidamente papel fundamental no tratamento da doença do refluxo gastroesofágico. Entretanto, o melhor método para as grandes hérnias paraesofágicas (tipos III e IV) ainda está em discussão. O uso de próteses para reforço da hiatoplastia tem sido proposto por diversos autores, no intuito de diminuir as altas taxas de recidivas encontradas nesses pacientes. Riscos de estenose e erosão da prótese são as complicações mais preocupantes quando se pensa em aplicar uma prótese no hiato esofágico. Objetivo -Demonstrar a técnica cirúrgica e resultados do uso de um modelo de tela idealizado no serviço dos autores para reforçar a hiatoplastia em grandes hérnias de hiato. Métodos -Uma prótese de polipropileno foi aplicada para reforço da hiatoplastia em pacientes com grandes hérnias de hiato (Tipos II a IV de Hill). A prótese ...

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“…26) Many reports in various hernia size and surgical technique followed. [27][28][29][30] Although there is no randomized control study comparing laparoscopic surgery to open procedures, laparoscopic repair has already become a standard care. Nguyen et al 31) has recently published a paper, which retrospectively compared 2069 laparoscopic, and 657 open repair of PHH.…”

Section: Operative Issuesmentioning

confidence: 99%

“…[58][59][60][61] It should be noted that recurrent, severe symptoms, requiring surgical revision, account for no more than 3 % of these failures. 28,62,63) The use of prosthetic material to reinforce the hernia repair has been proposed either routinely or in case of large hiatal gap, in order to reduce hernia recurrence to rates well below 10%. [64][65][66] However, there are several arguments against the use of prosthesis, mainly because available literature is not of a high level of evidence regarding study design and lack of long-term functional outcomes.…”

Section: Crural Repairmentioning

confidence: 99%

Paraesophageal Hernia Repair

Mori

Nagao

Sugiyama

2012

Ann Thorac Cardiovasc Surg

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Paraesophageal hiatal hernia (PHH), accounting for only 5% of all hiatal hernias, may result in potentially life threatening complications such as obstruction, acute dilatation, perforation, or bleeding of the gastric mucosa. It is traditionally believed that PHH is an indication for surgery. The repair of paraesophageal hernia is technically challenging and controversial. The purpose of this article is to overview the current status of indication of surgery; operative techniques including hernia sac resection, esophageal lengthening procedure, crural repair, and additional antireflux procedure. Results: All symptomatic patients should be surgically treated, when operation is possible. It seems reasonable that asymptomatic or minimally symptomatic patients do not necessarily require surgery and that a more selective approach should be used. The penetration rate is not high, laparoscopic approach is currently the standard care. The hernia sac should be excised and resected circumferentially. Collis-Nissen procedure continues to be the method of choice also in the laparoscopic era, when lengthening procedure of the shortened esophagus is in consideration. Although symptomatic recurrence after suture closure of the crura is uncommon, primary repair is associated with a high rate of anatomic recurrence. Prosthetic mesh repair is reportedly associated with a recurrence rate as low as 5%, at the price of rare but serious complications such as erosion and fibrosis. Although scientific proof is lacking, fundoplication is the most common procedure to be added after crural repair.

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Long-term outcome of laparoscopic repair of paraesophageal hernia

Cited by 189 publications

References 12 publications

Para-oesophageal and parahiatal hernias in an Asian acute care tertiary hospital: an underappreciated surgical condition

Para-oesophageal and parahiatal hernias in an Asian acute care tertiary hospital: an underappreciated surgical condition

Tela de polipropileno no reparo laparoscópico de grandes hérnias hiatais: aspectos técnicos

Paraesophageal Hernia Repair

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