Repair of symptomatic paraesophageal hernias in elderly (&gt;70 years) patients results in sustained quality of life at 5 years and beyond

Merzlikin, Oleg V.; Louie, Brian E.; Farivar, Alexander S.; Shultz, Dale; Aye, Ralph W.

doi:10.1007/s00464-017-5432-1

Cited by 11 publications

(12 citation statements)

References 14 publications

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“…[ 23 28 39 46 55 ] Two studies found that there was no significant increase in post-surgical QoL. [ 56 57 ]…”

Section: Resultsmentioning

confidence: 99%

“…Five studies[ 5 24 25 30 57 ] looked at QoL after repair of GHH with focus on the age demographic of patients [ Table 4 ]. Parker et al .…”

Section: Resultsmentioning

confidence: 99%

“…Merzlikin et al ., in carefully selected patients, showed improved QoL that sustained at 5 years and beyond. [ 57 ] The data from the study by Louie et al . also support repair of symptomatic GHH in patients aged 70 years or more;[ 24 ] the authors conclude that GHH in the elderly can be repaired with minimal surgical mortality and acceptable morbidity in both elective and urgent settings.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies[ 18 23 29 46 52 55 57 ] used Collis gastroplasty in many of their patients to reduce the chance of recurrence [ Table 8 ]. All studies showed improvement in QoL, with >77% excellent or good outcomes reported in four studies[ 23 29 46 55 ] and statistical significance in a further three studies.…”

Section: Resultsmentioning

confidence: 99%

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Quality of life after giant hiatus hernia repair

Date

Goh

et al. 2021

Journal of Minimal Access Surgery

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Background: Elective surgery is the treatment of choice for symptomatic giant hiatus hernia (GHH), and quality of life (QoL) has become an important outcome measure following surgery. The aim of this study is to review the literature assessing QoL following repair of GHH. Methodology: A systematic literature search was performed by two reviewers independently to identify original studies evaluating QoL outcomes after GHH surgery. MeSH terms such as paraoesophageal; hiatus hernia; giant hiatus hernia and quality of life were used in the initial search. Original studies in English language using validated questionnaires on humans were included. Review articles, conference abstracts and case reports and studies with duplicate data were excluded. Results: Two hundred and eight articles were identified on initial search, of which 38 studies (4404 patients) were included. Studies showed a significant heterogeneity in QoL assessment tools, surgical techniques and follow-up methods. All studies assessing both pre-operative and post-operative QoL ( n = 31) reported improved QoL on follow-up after surgical repair of GHH. Improvement in QoL following GHH repair was not affected by patient age, surgical technique or the use of mesh. Recurrence of GHH after surgery may, however, adversely impact QoL. Conclusion: Surgical repair of GHH improved QoL scores in all the 38 studies. The impact of recurrence on QoL needs further assessment. The authors also recommend uniform reporting of surgical outcomes in future studies.

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“…[ 23 28 39 46 55 ] Two studies found that there was no significant increase in post-surgical QoL. [ 56 57 ]…”

Section: Resultsmentioning

confidence: 99%

“…Five studies[ 5 24 25 30 57 ] looked at QoL after repair of GHH with focus on the age demographic of patients [ Table 4 ]. Parker et al .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Quality of life after giant hiatus hernia repair

Date

Goh

et al. 2021

Journal of Minimal Access Surgery

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“…There is a paucity of high-level evidence literature on elective PEH repair in elderly patients. A few studies defined elderly as > 70 years [3, 8, 9] or analyzed a very small group of elderly patients [5, 7, 10, 16], making comparison with our data difficult. Only one study evaluating elective PEH repair in 313 patients ≥ 80 years revealed a significant increase in minor morbidity (8.3% vs. 3.5%, p < 0.001), and a trend towards slightly higher mortality (1% vs. 0.4%, p = 0.16) and major morbidity (5.8% vs. 3.7%, p = 0.083) for patients ≥ 80 years [11].…”

Section: Discussionmentioning

confidence: 99%

Outcome of laparoscopic paraesophageal hernia repair in octogenarians: a registry-based, propensity score-matched comparison of 360 patients

et al. 2018

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Background Paraesophageal hernias (PEH) tend to occur in elderly patients and the assumed higher morbidity of PEH repair may dissuade clinicians from seeking a surgical solution. On the other hand, the mortality rate for emergency repairs shows a sevenfold increase compared to elective repairs. This analysis evaluates the complication rates after elective PEH repair in patients 80 years and older in comparison with younger patients. Methods In total, 3209 patients with PEH were recorded in the Herniamed Registry between September 1, 2009 and January 5, 2018. Using propensity score matching, 360 matched pairs were formed for comparative analysis of general, intraoperative, and postoperative complication rates in both groups. Results Our analysis revealed a disadvantage in general complications (6.7% vs. 14.2%; p = 0.002) for patients ≥ 80 years old. No significant differences were found between the two groups for intraoperative (4.7% vs. 5.8%, p = 0.627) and postoperative complications (2.2% vs. 2.8%, p = 0.815) or for complication-related reoperations (1.7% vs. 2.2%, p = 0.791). Conclusions Despite a higher risk of general complications, PEH repair in octogenarians is not in itself associated with increased rates of intraoperative and postoperative complications or associated reoperations. Therefore, PEH repair can be safely offered to elderly patients with symptomatic PEH, if general medical risk factors are controlled. Electronic supplementary material The online version of this article (10.1007/s00464-018-06619-4) contains supplementary material, which is available to authorized users.

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Age-related outcomes in laparoscopic hiatal hernia repair: Is there a “too old” for antireflux surgery?

et al. 2020

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Repair of symptomatic paraesophageal hernias in elderly (>70 years) patients results in sustained quality of life at 5 years and beyond

Abstract: In elderly patients with symptomatic PEH undergoing surgical repair more than 5 years ago, there was sustained improvement in quality of life. This justifies surgical repair of symptomatic PEH in elderly patients.

Cited by 11 publications

References 14 publications

Quality of life after giant hiatus hernia repair

Quality of life after giant hiatus hernia repair

Outcome of laparoscopic paraesophageal hernia repair in octogenarians: a registry-based, propensity score-matched comparison of 360 patients

Age-related outcomes in laparoscopic hiatal hernia repair: Is there a “too old” for antireflux surgery?

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