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Hiatal hernias

Michael Antiporda, Chloe Jackson, C Daniel Smith, Steven P Bowers
INTRODUCTION: Laparoscopic magnetic sphincter augmentation (MSA) has been shown to be efficacious therapy for gastroesophageal reflux disease (GERD) refractory to maximal medical management. Herein, we present our experience with this procedure and an analysis of our outcomes. MATERIALS AND METHODS: Medical records were retrospectively reviewed of 98 patients who underwent laparoscopic MSA for GERD at a single institution from 2012 to 2016. Symptoms were assessed with gastroesophageal reflux disease-health-related quality of life (GERD-HRQL) questionnaire...
December 15, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ryosuke Fujisawa, Yuji Akiyama, Takeshi Iwaya, Fumitaka Endo, Haruka Nikai, Shigeaki Baba, Takehiro Chiba, Toshimoto Kimura, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Masaru Mizuno, Keisuke Koeda, Akira Sasaki
BACKGROUND: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. CASE PRESENTATION: An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall...
December 13, 2018: Surgical Case Reports
Salvatore Docimo, Uzma Rahmana, Andrew Bates, Mark Talamini, Aurora Pryor, Konstantinos Spaniolas
Obesity is associated with the development of gastroesophageal reflux disease (GERD) and hiatal hernia (HH). This study aimed to assess practice patterns regarding concomitant HH repair (HHR) during laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The incidence of concomitant HHR with LSG or LRYGB was analyzed using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. One hundred thirty thousand, seven hundred seventy-two patients underwent RYGB (30...
December 7, 2018: Obesity Surgery
M A Burikov, I V Skazkin, O V Shulgin, I A Sokirenko, A I Kinyakin, M A Sanchenko
AIM: To assess an effectiveness of FAST TRACK rehabilitation in patients after laparoscopic repair of hiatal hernia. MATERIAL AND METHODS: There were 87 patients with hiatal hernia who underwent laparoscopic Nissen-Rossetti procedure with wrapping only anterior wall of the stomach. FAST TRACK approach was applied in 49 patients, standard protocol - in 38 cases. Effectiveness of FAST TRACK rehabilitation was assessed in this report considering early postoperative morbidity, length of hospital-stay, time of postoperative intestinal paresis, complaints by GSRS questionnaire...
2018: Khirurgiia
Farid Gharagozloo, Basher Atiquzzaman, Barbara Tempesta, R C Tolboom, Mark Meyer, Stephan Gruessner
PURPOSE: Nissen fundoplication is associated with poor long-term durability, as well as dysphasia and gas bloat. We report here the long-term results of modified Belsey fundoplication (Gastroesophageal Valvuloplasty; GEV) performed laparoscopically using a surgical robot. METHODS: Patients who underwent robotic GEV were reviewed retrospectively. Operations were performed by laparoscopy and included robotic dissection of the esophageal hiatus, primary closure of the hiatus, followed by intussusception of a 4 cm segment of the esophagus into the stomach for 270°, and suspension of the fundoplication on the hiatal closure...
November 30, 2018: Surgical Technology International
Elisa Stasi, Andrea Michielan, Gaetano Cristian Morreale, Alessandro Tozzi, Ludovica Venezia, Francesco Bortoluzzi, Omero Triossi, Marco Soncini, Gioacchino Leandro, Giuseppe Milazzo, Andrea Anderloni
Modern medicine provides almost infinite diagnostic and therapeutic possibilities if compared to the past. As a result, patients undergo a multiplication of tests and therapies, which in turn may trigger further tests, often based on physicians' attitudes or beliefs, which are not always evidence-based. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) adhered to the Choosing Wisely Campaign to promote an informed, evidence-based approach to gastroenterological problems. The aim of this article is to report the five recommendations of the AIGO Choosing Wisely Campaign, and the process used to develop them...
November 29, 2018: Internal and Emergency Medicine
Takayuki Nishi, Hiroyasu Makuuchi, Soji Ozawa, Hideo Shimada, Osamu Chino
BACKGROUND: The incidence of esophageal adenocarcinoma in Europe and the United States rapidly increased from the latter half of the 1970s and exceeded that of esophageal squamous cell carcinoma in the latter half of the 1990s, currently accounting for approximately 60% of all esophageal carcinomas. Recently, its incidence has also increased in Japan, raising concerns that it will follow a course similar to that in Europe and the United States. SUMMARY: The incidence of esophageal adenocarcinoma in Japan was about 2% until the 1990s, but in recent years, it has risen to 6...
November 27, 2018: Digestion
C Theodore Huerta, Margaret Plymale, Peter Barrett, Daniel L Davenport, John Scott Roth
BACKGROUND: Laparoscopic hiatal hernia repair via Toupet or Nissen fundoplication remains the most commonly performed procedures for management of large hiatal hernia. Few studies have compared the procedures' long-term effectiveness. This study sought to characterize the efficacy of laparoscopic Toupet versus Nissen fundoplication for types III and IV hiatal hernia. METHODS: With IRB approval, a review of all laparoscopic hiatal hernia repairs with mesh reinforcement performed over 7 years at a single center by one surgeon was conducted...
November 26, 2018: Surgical Endoscopy
Sonali R Gnanenthiran, Christopher Naoum, Dianna Hanzek, Zoya Pogrebizhsky, David Martin, Leonard Kritharides, John Yiannikas
BACKGROUND: Patients with large hiatal hernias (HH) frequently experience postprandial dyspnea. The aim of this study was to evaluate whether feeding induced cardiac compression in these patients using echocardiography. METHODS: Transthoracic echocardiography was performed during fasting and 30 min after feeding (300 g rice pudding) in patients with HHs (n = 32; mean age, 72 ± 9 years). A subset of patients (n = 15; mean age, 76 ± 6 years) were evaluated postoperatively...
November 22, 2018: Journal of the American Society of Echocardiography
Pranav Rajpurkar, Jeremy Irvin, Robyn L Ball, Kaylie Zhu, Brandon Yang, Hershel Mehta, Tony Duan, Daisy Ding, Aarti Bagul, Curtis P Langlotz, Bhavik N Patel, Kristen W Yeom, Katie Shpanskaya, Francis G Blankenberg, Jayne Seekins, Timothy J Amrhein, David A Mong, Safwan S Halabi, Evan J Zucker, Andrew Y Ng, Matthew P Lungren
BACKGROUND: Chest radiograph interpretation is critical for the detection of thoracic diseases, including tuberculosis and lung cancer, which affect millions of people worldwide each year. This time-consuming task typically requires expert radiologists to read the images, leading to fatigue-based diagnostic error and lack of diagnostic expertise in areas of the world where radiologists are not available. Recently, deep learning approaches have been able to achieve expert-level performance in medical image interpretation tasks, powered by large network architectures and fueled by the emergence of large labeled datasets...
November 2018: PLoS Medicine
Dag Holmberg, Eivind Ness-Jensen, Fredrik Mattsson, Jesper Lagergren
BACKGROUND: Individuals with Barrett's esophagus (BE) are at increased risk of high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC), but the cost-effectiveness of general surveillance of BE is low. This study aimed to identify a risk prediction model for tumor progression in individuals with BE based on age, sex, and risk factors found at upper endoscopy, enabling tailored surveillance. METHODS: This nested case-control study originated from a cohort of 8171 adults diagnosed with BE in 2006-2013 in the Swedish Patient Registry...
November 19, 2018: Surgical Endoscopy
Medhat Fanous, Wei Wei, Anja Jaehne, David Lorenson
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
Nogah Nativ-Zeltzer, Anaïs Rameau, Maggie A Kuhn, Matthew Kaufman, Peter C Belafsky
Although the precise etiology of cricopharyngeus muscle (CPM) dysfunction (CPMD) is uncertain, many have hypothesized that a hypertrophied CPM may develop as a protective compensation against gastroesophageal reflux disease (GERD). The purpose of this investigation was to evaluate the association between CPMD and the presence of hiatal hernia (HH) in an attempt to elucidate the potential etiology of CPMD. The charts of individuals who underwent video fluoroscopic esophagrams between 01/01/14 and 10/30/16 were reviewed from an electronic database...
November 7, 2018: Dysphagia
Parisa Mazaheri, David H Ballard, Kevin A Neal, Demetrios A Raptis, Anup S Shetty, Constantine A Raptis, Vincent M Mellnick
OBJECTIVE: The objective of this study was to identify CT findings and determine interobserver reliability of surgically proven gastric volvulus. MATERIALS AND METHODS: This single-center retrospective study included 30 patients (21 women, nine men; mean age, 73 years old) with surgically proven gastric volvulus who underwent preoperative CT and 31 age- and sex-matched control subjects (21 women, nine men; mean age, 74 years old) with large hiatal hernias who were imaged for reasons other than abdominal pain...
November 7, 2018: AJR. American Journal of Roentgenology
Medhat Fanous, Wei Wei, Anja Jaehne, David Lorenson
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
James M Tatum, Evan Alicuben, Nikolai Bildzukewicz, Kamran Samakar, Caitlin C Houghton, John C Lipham
BACKGROUND: Recurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. Device removal has been previously reported, and outcomes of various surgical management strategies at the time of removal have not been well described. METHODS: This is a retrospective review of patients undergoing MSA removal from March 2009 to September 2017 in a single institution. Reason for removal, operative management, and short-term outcomes are reported...
November 1, 2018: Surgical Endoscopy
Medhat Fanous, Wei Wei, Anja Jaehne, David Lorenson
No abstract text is available yet for this article.
July 1, 2018: American Surgeon
Ahmad Alkaddour, Camille McGaw, Rama Hritani, Carlos Palacio, Juan Carlos Munoz, Kenneth J Vega
BACKGROUND AND STUDY AIMS: Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. The study aim was to determine which clinical factors may be associated with the ethnic variation seen in histologically confirmed BE among a general population. PATIENTS AND METHODS: The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to October 2012...
October 23, 2018: Journal of the National Medical Association
Kamthorn Yolsuriyanwong, Eric Marcotte, Mukund Venu, Bipan Chand
BACKGROUND: Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. This information may change subsequent operations. The aim of this study was to evaluate the impact of VNI testing in patients with prior thoracic or gastric surgery...
October 25, 2018: Surgical Endoscopy
Alexander C Mertens, Rob C Tolboom, Hana Zavrtanik, Werner A Draaisma, Ivo A M J Broeders
INTRODUCTION: Published data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center. MATERIALS AND METHODS: All patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated...
October 22, 2018: Surgical Endoscopy
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