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paraesophageal hernia repair

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https://www.readbyqxmd.com/read/28770418/acute-vs-elective-paraesophageal-hernia-repair-endoscopic-gastric-decompression-allows-semi-elective-surgery-in-a-majority-of-acute-patients
#1
Andrea Wirsching, Moustapha A El Lakis, Kamran Mohiuddin, Agostino Pozzi, Michal Hubka, Donald E Low
BACKGROUND: Historically, patients presenting acutely with paraesophageal hernia and requiring urgent operation demonstrated inferior outcomes compared to patients undergoing elective repair. METHODS: A prospective IRB-approved database was used to retrospectively review 570 consecutive patients undergoing paraesophageal hernia repair between 2000 and 2016. RESULTS: Thirty-eight patients presented acutely (6.7%) and 532 electively. Acute presentation was associated with increased age (74 vs...
August 2, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28770120/laparoscopic-repair-of-a-large-paraesophageal-hernia-with-migration-of-the-stomach-into-the-mediastinum-creating-an-upside-down-stomach
#2
Nasser Sakran, Hadar Nevo, Ron Dar, Asnat Raziel, Dan Hershko
Upside-down stomach is a relatively rare type of a large paraesophageal hernia characterized by the migration of the stomach into the posterior mediastinum. Upside-down stomach is prone to severe complications and therefore surgery is recommended even in asymptomatic patients. A 62-year-old male presented with frequent abdominal pain with nausea and vomiting that persisted for one year. The patient was obese with fatty liver and was treated medically for gastroesophageal reflux disease (GERD) for 4 years. On upper gastrointestinal CT study a level-IV paraesophageal hernia was detected with upside-down stomach, and he was referred for elective surgery...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28733735/laparoscopic-repair-of-giant-paraesophageal-hernia-are-there-factors-associated-with-anatomic-recurrence
#3
Michael Antiporda, Benjamin Veenstra, Chloe Jackson, Pujan Kandel, C Daniel Smith, Steven P Bowers
BACKGROUND: Repair of giant paraesophageal hernia (PEH) is associated with a favorably high rate of symptom improvement; however, rates of recurrence by objective measures remain high. Herein we analyze our experience with laparoscopic giant PEH repair to determine what factors if any can predict anatomic recurrence. METHODS: We prospectively collected data on PEH characteristics, variations in operative techniques, and surgeon factors for 595 patients undergoing laparoscopic PEH repair from 2008 to 2015...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28693045/hiatal-hernia-repair-current-evidence-for-use-of-absorbable-mesh-to-reinforce-hiatal-closure
#4
Lucian Panait, Yuri W Novitsky
INTRODUCTION: There continues to be debate regarding the best surgical technique for the treatment of paraesophageal hernias. While laparoscopic and robotic approaches are widely employed around the world, the benefits of mesh use to reinforce hiatal closure are still not well established. The goal of this manuscript is to describe the currently available results with biologic and bioabsorbable meshes for treatment of paraesophageal hernias, particularly with reference to the rate of recurrence...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28678999/association-of-centers-for-medicare-medicaid-services-overall-hospital-quality-star-rating-with-outcomes-in-advanced-laparoscopic-abdominal-surgery
#5
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Ninh T Nguyen
Importance: The Centers for Medicare & Medicaid Services (CMS) recently released the Overall Hospital Quality Star Rating to help patients compare hospitals based on a 5-star scale. The star rating was designed to assess overall quality of the institution; thus, its validity toward specifically assessing surgical quality is unknown. Objective: To examine whether CMS high-star hospitals (HSHs) have improved patient outcomes and resource use in advanced laparoscopic abdominal surgery compared with low-star hospitals (LSHs)...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28664605/case-of-giant-paraesophageal-hiatal-hernia-associated-with-morgagni-hernia
#6
Hiroki Ozawa, Hiroharu Shinozaki, Masaru Kimata, Soji Ozawa
Simultaneous paraesophageal and Morgagni hernias are very rare. Here, we report a case involving a 91-year-old woman with simultaneous paraesophageal and Morgagni hernias. Both hernias were repaired laparoscopically. The postoperative course was uneventful. Laparoscopic repair for hernias seems to be feasible and minimally invasive, but only a few reports have described such repairs of hernial orifices.
June 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28608040/paraesophageal-hernia-repair-in-the-usa-trends-of-utilization-stratified-by-surgical-volume-and-consequent-impact-on-perioperative-outcomes
#7
Francisco Schlottmann, Paula D Strassle, Marco E Allaix, Marco G Patti
BACKGROUND: The impact of surgical volume on perioperative results after a paraesophageal hernia (PEH) repair has not yet been analyzed. We sought to characterize the trend of utilization of this procedure stratified by surgical volume in the USA, and analyze its impact on perioperative outcomes. METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013. Adult patients (≥18 years old) who underwent PEH repair were included...
August 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28597286/what-are-the-differences-in-the-outcome-of-laparoscopic-axial-i-versus-paraesophageal-ii-iv-hiatal-hernia-repair
#8
F Köckerling, Y Trommer, K Zarras, D Adolf, B Kraft, D Weyhe, R Fortelny, C Schug-Paß
INTRODUCTION: Comparison of elective laparoscopic repair of axial vs paraesophageal hiatal hernias reveals relevant differences in both the patient collectives and the complexity of the procedures. MATERIALS AND METHODS: The present uni- and multivariable analysis of data from the Herniamed Registry compares the outcome for 2047 (67.3%) (type I) axial with 996 (32.7%) (types II-IV) paraesophageal primary hiatal hernias following laparoscopic repair. RESULTS: Compared with the patients with axial hiatal hernias, patients with paraesophageal hiatal hernia were nine years older, had a higher ASA score (ASA III/IV: 34...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28594583/impact-of-surgeon-specialty-on-perioperative-outcomes-of-surgery-for-benign-esophageal-diseases-a-nsqip-analysis
#9
Zeyad Khoshhal, Joseph Canner, Eric Schneider, Miloslawa Stem, Elliott Haut, Francisco Schlottmann, Arianna Barbetta, Benedetto Mungo, Anne Lidor, Daniela Molena
BACKGROUND: Surgery for benign esophageal disease is mostly performed either by general surgeons (GS) or cardiothoracic surgeons (CTS) in the United States. The purpose of this study was to evaluate the effect of surgeon specialty on perioperative outcomes of surgery for benign esophageal diseases. MATERIALS AND METHODS: We have conducted a retrospective analysis using the ACS-NSQIP during the period of 2006-2013. Patients who underwent paraesophageal hernia (PEH) repair, gastric fundoplication, or Heller esophagomyotomy were divided into two groups according to the specialty of the surgeon (GS or CTS)...
June 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28550872/hiatal-and-paraesophageal-hernia-repair-in-pediatric-patients
#10
Erin M Garvey, Daniel J Ostlie
Hiatal and paraesophageal hernia (HH/PEH) can be congenital, resulting from embryologic abnormalities/genetic predisposition, or acquired, most commonly after gastroesophageal surgery such as fundoplication. Minimizing circumferential esophageal dissection at the time of Nissen fundoplication has been shown to decrease the risk of acquired HH/PEH from 36.5% to 12.2%. Gastrointestinal, respiratory, and constitutional symptoms, including anemia and failure to thrive, are common with high rates of associated gastroesophageal reflux...
April 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28550394/laparoscopic-paraesophageal-hernia-repair-utilization-rates-of-mesh-in-the-usa-and-short-term-outcome-analysis
#11
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Many studies have shown that the utilization of mesh for paraesophageal hernia repair (PEHR) does not prevent recurrence. The aims of this study were (a) to assess the utilization of mesh for PEHR in the USA and (b) to compare the perioperative outcomes between PEHR with and without mesh. METHODS: A retrospective population-based analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
May 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28502624/prospective-study-of-giant-paraesophageal-hernia-repair-with-1-year-follow-up
#12
John R Stringham, Jennifer V Phillips, Timothy L McMurry, Drew L Lambert, David R Jones, James M Isbell, Christine L Lau, Benjamin D Kozower
OBJECTIVE: Evaluating giant paraesophageal hernia (GPEH) repair requires long-term follow-up. GPEH repair can have associated high recurrence rates, yet this incidence depends on how recurrence is defined. Our objective was to prospectively evaluate patients undergoing GPEH repair with 1-year follow-up. METHODS: Patients undergoing elective GPEH repair between 2011 and 2014 were enrolled prospectively. Postoperatively, patients were evaluated at 1 month and 1 year...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28493161/primary-versus-redo-paraesophageal-hiatal-hernia-repair-a-comparative-analysis-of-operative-and-quality-of-life-outcomes
#13
H Reza Zahiri, Adam S Weltz, Udai S Sibia, Neethi Paranji, Steven D Leydorf, George T Fantry, Adrian E Park
INTRODUCTION: We compared patient outcomes after initial versus redo paraesophageal hernia (PEH) repair at two high-volume GI surgery centers. MATERIALS AND METHODS: Retrospective review analyzed one-year outcomes after initial versus redo elective laparoscopic PEH repair, including wound/non-wound-related complications and quality of life benefits as measured by four validated instruments: reflux symptom index, gastroesophageal reflux disease health-related, laryngopharyngeal reflux, and swallowing scales...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28492357/long-term-effectiveness-of-strattice-in-the-laparoscopic-closure-of-paraesophageal-hernias
#14
Daniel Lomelin, Alicia Smith, Nathan Bills, Amareshewar Chiruvella, Christopher Crawford, Crystal Krause, Robert Bayer, Dmitry Oleynikov
Prosthetic reinforcement reduces the recurrence rate of large paraesophageal hernias (PEH), but the use of synthetic or biosynthetic mesh in the repair remains controversial. PEH repair has reported recurrence rates of 12% to 42%, and primary repair of PEH by suture closure under tension is at high risk of disruption. Synthetic mesh use in large PEH repair has shown to reduce recurrence but can lead to problems including mesh erosion, ulceration, stricture, and dysphagia. The objective of this study was to examine the long-term safety and efficacy of Strattice biologic mesh, a porcine acellular dermal matrix, in crural reinforcement of laparoscopic large PEH repair...
June 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28484816/paraesophageal-hernia-and-reflux-prevention-is-one-fundoplication-better-than-the-other
#15
REVIEW
Ciro Andolfi, Alejandro Plana, Sara Furno, Piero Marco Fisichella
BACKGROUND: The management of paraesophageal hernia (PEH) is one of the most debated in surgery. Trends regarding indications, approach (open, laparoscopic, thoracoscopic), sac excision, mesh placement, and routine performance of fundoplication have changed over time. Today, most surgeons tend to perform a laparoscopic PEH repair that entails the excision of the sac, liberal use of a mesh to buttress the hiatus, and the addition of an anti-reflux procedure. Nevertheless, very little has been written on which type of fundoplication should be performed in these patients...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28433224/the-importance-of-age-on-short-term-outcomes-associated-with-repair-of-giant-paraesophageal-hernias
#16
COMPARATIVE STUDY
Mustapha A El Lakis, Stephen J Kaplan, Michal Hubka, Kamran Mohiuddin, Donald E Low
BACKGROUND: Older patients have an increased incidence of paraesophageal hernia (PEH) and can be denied surgical assessment due to the perception of increased complications and mortality. This study examines the influence of age and comorbidities on early complications and other short-term outcomes of PEH repair. METHODS: From 2000 to 2016, data of surgically treated patients with PEH were prospectively recorded in an Institutional Review Board-approved database...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28375479/temporal-patterns-of-hiatus-hernia-recurrence-and-hiatal-failure-quality-of-life-and-recurrence-after-revision-surgery
#17
A Suppiah, P Sirimanna, S J Vivian, H O'Donnell, G Lee, G L Falk
Antireflux and paraesophageal hernia repair surgery is increasingly performed and there is an increased requirement for revision hiatus hernia surgery. There are no reports on the changes in types of failures and/or the variations in location of crural defects over time following primary surgery and limited reports on the outcomes of revision surgery. The aim of this study is to report the changes in types of hernia recurrence and location of crural defects following primary surgery, to test our hypothesis of the temporal events leading to hiatal recurrence and aid prevention...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28374223/robotic-paraesophageal-hernia-repair-a-single-center-experience-and-systematic-review
#18
Vanitha Vasudevan, Ryan Reusche, Erek Nelson, Srinivas Kaza
Robotic Surgery is becoming increasingly used in general surgery. The objective of this study is to evaluate the safety, effectiveness and short-term (less than 1 year) outcomes of Robotic Paraesophageal Hernia (RPEH) Surgery using the DaVinci Surgical Robot system (Intuitive Surgical, CA) in a large community hospital. This is a retrospective cohort study of 28 consecutive patients who underwent robotic paraesophageal hernia repair January 2011-March 2013 in this institution. Data and outcomes collected for analysis include patient demographics, operating times, conversion, complications, mortality and recurrence...
April 3, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28372456/paraesophageal-hernia-and-gastric-volvulus-an-uncommon-etiology-of-vomiting-and-upper-gastrointestinal-bleeding
#19
Gonçalo Nunes, Marta Patita, Vítor Fernandes, Jorge Fonseca
The authors report the case of a 75 year-old woman admitted to the emergency room with abdominal pain and coffee ground vomiting. Marked epigastric distension with tenderness and signs of severe dehydration were present. Upper GI endoscopy showed a black esophagus covered by a large amount of dark fluid, diffuse hyperaemia and superficial erosions. Marked distortion of gastric anatomy caused by stomach rotation and a large paraesophageal hernia was observed and the pylorus was not identified. Chest X-ray and CT scan confirmed the presence of an organoaxial gastric volvulus with antero superior rotation and incarceration of the gastric antrum, which was located above the diaphragm...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28364150/repair-of-symptomatic-paraesophageal-hernias-in-elderly-70%C3%A2-years-patients-results-in-sustained-quality-of-life-at-5%C3%A2-years-and-beyond
#20
Oleg V Merzlikin, Brian E Louie, Alexander S Farivar, Dale Shultz, Ralph W Aye
BACKGROUND: Paraesophageal hernias (PEHs) involve herniation of stomach and/or other viscera into the mediastinum. These commonly occur in the elderly and can severely limit quality of life. Short term outcomes of repaired PEH demonstrated low morbidity and significant improvement in quality of life, but long-term data for all patients, especially the elderly, are lacking. METHODS: Retrospective chart review of a prospectively collected database of patients aged 70 or greater with a symptomatic PEH repaired 5+ years ago...
March 31, 2017: Surgical Endoscopy
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