Reoperative laparoscopic paraesophageal herniorrhaphy can produce excellent outcomes

Abstract

Our data demonstrate that reoperative laparoscopic paraesophageal herniorrhaphy can produce excellent results, comparable to first-time repair.

The Choice of Primary Repair or Mesh Repair for Paraesophageal Hernia

“…To avoid overweighting of data from centers with multiple publications, when more than 1 study was published by a center, the latest published study with the largest sample size and the longest follow-up was used unless the center published other studies which contained information that was useful for the decision analysis in one study but not in another. Tables 2 19-45 and 3 21,[26][27][28][29][30][31][33][34][35][36][37][38]41,42,[44][45][46][47][48][49] present the references with the data sources used in this decision analysis.…”

“…The outcome state of a patient who has a recurrence but is not reoperated upon and is asymptomatic will be given a score of 100 (based on the premise that from the patient's perspective, a conversion of a symptomatic PEH to an asymptomatic hiatal hernia would be the same as not suffering from a PEH at all), whereas one who is symptomatic is given a score of 90, based on existing quality of life data of patients with symptomatic PEH, which shows that quality of life scores for patients with PEH are about 10% lower than the general population. 2,37,44,55 The outcome state of a patient who has a reoperation and has a good outcome will have a score of 95 (it is clearly preferable not to have a reoperation, but a reoperation with a good outcome is preferable to continued symptoms. Therefore, the score was assigned midway between the most preferred state and Decision tree for primary repair.…”