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paraesophageal hernia repair

Nazan Ülgen-Tekerek, Başak Akyıldız, Alper Özcan, Ayşe Betül Ergül, Cüneyt Turan, Serdal Özcan
Late presentation of congenital diaphragmatic hernia is 5-30% of all congenital diaphragma hernia cases. It can present as Morgagni, Bochdalek and paraesophageal hernia. Misdiagnosis can result in significant morbiditiy. A 17-month-old girl presented with vomiting and abdominal pain. On physical examination, circulatory disturbance, cyanosis, abdominal distantion were present. Her O2 saturation was 60% and she was tachycardic (180 bpm) and tachypneic (58 bpm) with hypotension (60/35 mmhg). Patient's heart and mediastinum were shifted into the right hemithorax on the chest X-ray...
November 2015: Turkish Journal of Pediatrics
Munyaradzi Chimukangara, Melissa C Helm, Matthew J Frelich, Matthew E Bosler, Lisa E Rein, Aniko Szabo, Jon C Gould
BACKGROUND: Frailty is a measure of physiologic reserve associated with increased vulnerability to adverse outcomes following surgery in older adults. The 'accumulating deficits' model of frailty has been applied to the NSQIP database, and an 11-item modified frailty index (mFI) has been validated. We developed a condensed 5-item frailty index and used this to assess the relationship between frailty and outcomes in patients undergoing paraesophageal hernia (PEH) repair. METHODS: The NSQIP database was queried for ICD-9 and CPT codes associated with PEH repair...
October 3, 2016: Surgical Endoscopy
Jessica A Zaman, Anne O Lidor
While the asymptomatic paraesophageal hernia (PEH) can be observed safely, surgery is indicated for symptomatic hernias. Laparoscopic repair is associated with decreased morbidity and mortality; however, it is associated with a higher rate of radiologic recurrence when compared with the open approach. Though a majority of patients experience good symptomatic relief from laparoscopic repair, strict adherence to good technique is critical to minimize recurrence. The fundamental steps of laparoscopic PEH repair include adequate mediastinal mobilization of the esophagus, tension-free approximation of the diaphragmatic crura, and gastric fundoplication...
October 2016: Current Gastroenterology Reports
José Ángel Díez Ares, Nuria Peris Tomás, Nuria Estellés Vidagany, Dolores Periáñez Gómez
Asymptomatic giant hiatal hernia comprises a relatively common disease, mostly presented in women with 50 years onwards. The therapeutic approach remains controversial in recent years. Under the latest SAGES`revision, all the symptomatic hernias must be repaired, but the symptomatic hiatal hernia definition isn`t even now established. We present the case os a A 67 - year old woman with an asymptomatic hiatal hernia, that is admitted to our hospital owing to toracic and abdominal pain. This pain was related with food intake for 6 months...
August 2016: Revista Española de Enfermedades Digestivas
Vernissia Tam, James D Luketich, Daniel G Winger, Inderpal S Sarkaria, Ryan M Levy, Neil A Christie, Omar Awais, Manisha R Shende, Katie S Nason
INTRODUCTION: Patients undergoing non-elective paraesophageal hernia repair (PEHR) have worse perioperative outcomes. Because they are usually older and sicker, however, these patients may be more prone to adverse events, independent of surgical urgency. Our study aimed to determine whether non-elective PEHR is associated with differential postoperative outcome compared to elective repair, using propensity-score weighting. METHODS: We abstracted data for patients undergoing PEHR (n = 924; non-elective n = 171 (19 %); 1997-2010)...
August 4, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Gal Levy, Ralph W Aye, Alexander S Farivar, Brian E Louie
INTRODUCTION: We compared clinical and objective outcomes of combined Nissen-Hill hybrid (HYB) to Nissen fundoplication (LNF) for repair of paraesophageal hernia (PEH). METHODS: This study is a single-institution retrospective chart review of prospectively collected data for consecutive patients undergoing PEH repair from 2006 to 2015 with at least 6 months of follow-up. Quality of life metrics (QOLRAD, HRQL, and dysphagia), manometry, radiographic imaging, and pH testing were administered pre- and postoperatively...
August 4, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
David M Parker, Amrit A Rambhajan, Ryan D Horsley, Kathleen Johanson, Jon D Gabrielsen, Anthony T Petrick
BACKGROUND: Paraesophageal hernias (PEHs) occur frequently in the elderly. Patients may not be referred for repair due to age or concern for high operative morbidity and mortality. The aim of this study was to compare outcomes of PEH repair based on age. METHODS: Adult patients undergoing PEH repair between 2003 and 2012 at a tertiary referral center were included. Patients were divided by age (Y < 69, YO 70-79 and VO > 80). Body mass index (BMI), Charlson comorbidity index, operative time, estimated blood loss, length of stay, recurrence, Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) scores, morbidity and mortality were analyzed...
July 15, 2016: Surgical Endoscopy
Ciro Andolfi, Anahita Jalilvand, Alejandro Plana, P Marco Fisichella
The management of paraesophageal hernia (PEH) can be challenging due to the lack of consensus regarding indications and principles of operative treatment. In addition, data about the pathophysiology of the hernias are scant. Therefore, the goal of this review is to shed light and describe the classification, pathophysiology, clinical presentation, and indications for treatment of PEHs, and provide an overview of the surgical management and a description of the technical principles of the repair.
July 11, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Amy K Poupore, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Our aim was to ascertain the incidence of, reasons for, and risk factors associated with hospital readmission after an operation for benign distal esophageal disease. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database (2012-2014), patients with a primary diagnosis of gastroesophageal reflux disease, paraesophageal hiatal hernia, or achalasia who underwent fundoplication, paraesophageal hernia repair, or Heller myotomy were identified...
September 2016: Surgery
Munyaradzi Chimukangara, Matthew J Frelich, Matthew E Bosler, Lisa E Rein, Aniko Szabo, Jon C Gould
BACKGROUND: Frailty is a measure of physiological reserve that has been used to predict outcomes after surgical procedures in the elderly. We hypothesized that frailty would be associated with outcomes after paraesophageal hernia (PEH) repair. METHODS: The National Surgical Quality Improvement Program database (2011-2013) was queried for International Classification of Diseases, Version 9 and Current Procedural Terminology codes associated with PEH repair in patients aged ≥ 60 y...
May 15, 2016: Journal of Surgical Research
Carlos A Galvani, Hannah Loebl, Obiyo Osuchukwu, Julia Samamé, Matthew E Apel, Iman Ghaderi
BACKGROUND: Laparoscopic surgery is considered the standard approach for the treatment of paraesophageal hernias (PEHs). Despite its advantages, this approach is technically demanding with a significant learning curve. Data about the safety and utility of the robotically assisted paraesophageal hernia repair (RA-PEHR) are scarce. The aim of this study is to assess the feasibility and safety of robotic assistance for the treatment of PEH. MATERIALS AND METHODS: Between June 2010 and December 2015, patients who underwent elective RA-PEHR were included in a prospectively collected database...
April 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
P Priego, J Perez de Oteyza, J Galindo, P Carda, F García-Moreno, G Rodríguez Velasco, E Lobo
PURPOSE: The application of mesh-reinforced hiatal closure has resulted in a significant reduction in recurrence rates in comparison with primary suture repair. However, the use of meshes has not completely extended in all the cases of large paraesophageal hiatal hernias (LPHH) due to the complications related to them. The aim of this study is to present our long-term results and complications related to Crurasoft(®) mesh (Bard) for the treatment of LPHH. METHODS: From January 2004 to December 2014, 536 consecutive patients underwent open or laparoscopic fundoplication for gastroesophageal reflux disease or LPHH at Ramón y Cajal University Hospital...
March 29, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Inderpal S Sarkaria, M Jawad Latif, Valentino J Bianco, Manjit S Bains, Valerie W Rusch, David R Jones, Nabil P Rizk
BACKGROUND: We have previously described our technique of robotic-assisted giant paraesophageal hernia repair (RA-GPEHR). The purpose of this study was to report our initial experience, early outcomes and learning curve with RA-GPEHR using a four-arm robotic platform. METHODS: 24 consecutive patients presenting with symptomatic giant paraesophageal hernias (GPEH) underwent RA-GPEHR from April 2011 to February 2014. Peri-operative data and short-term patient outcomes were assessed by retrospective review of a prospectively maintained database...
February 29, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Ye Xin Koh, Lester Wei Lin Ong, June Lee, Andrew Siang Yih Wong
INTRODUCTION: The prevalence of hiatal hernias and paraesophageal hernias (PEHs) is lower in Asian populations than in Western populations. Progressive herniation can result in giant PEH, which is associated with significant morbidity. This article presents the experience of an Asian, acute care, tertiary hospital in the management of giant PEH and parahiatal hernia. METHODS: Surgical records dated between January 2003 and January 2013 from the Department of Surgery, Changi General Hospital, Singapore, were retrospectively reviewed...
January 15, 2016: Singapore Medical Journal
Jonathan M Bock, Michael J Knabel, Daniel A Lew, Paul M Knechtges, Jon C Gould, Benson T Massey
Killian-Jamieson diverticulum is a outpouching of the lateral cervical esophageal wall adjacent to the insertion of the recurrent laryngeal to the larynx and is much less common in clinical practice than Zenkers Diverticulum. Surgical management of Killian-Jamieson diverticulum requires open transcervical diverticulectomy due to the proximity of the recurrent laryngeal nerve to the base of the pouch. We present a case of a Killian-Jamieson diverticulum associated with a concurrent large type III paraesophageal hernia causing significant solid-food dysphagia, post-prandial regurgitation of solid foods, and chronic cough managed with open transcervical diverticulectomy and laparoscopic paraesophageal hernia repair with Nissen fundoplication...
August 2016: Dysphagia
John Wennergren, Salomon Levy, Curtis Bower, Michael Miller, Daniel Borman, Daniel Davenport, Margaret Plymale, J Scott Roth
BACKGROUND: Recurrent paraesophageal hernia (PEH) repair is performed for symptomatic recurrent hiatal hernia and/or reflux with little understanding as to outcomes related to perioperative and subjective patient variables. The aim of this study was to understand what differences exist between patients undergoing initial paraesophageal hernia (IPEH) repair and those undergoing redo paraesophageal hernia (RPEH) repair. METHODS: A review of PEH repairs between 2009 and 2013 was performed from a single institution...
September 2016: Surgical Endoscopy
Matthew Davis, John Rodriguez, Kevin El-Hayek, Stacy Brethauer, Philip Schauer, Andrea Zelisko, Bipan Chand, Colin O'Rourke, Matthew Kroh
BACKGROUND AND OBJECTIVES: Treatment of gastroesophageal reflux disease (GERD) with hiatal hernia in obese patients has proven difficult, as studies demonstrate poor symptom control and high failure rates in this patient population. Recent data have shown that incorporating weight loss procedures into the treatment of reflux may improve overall outcomes. METHODS: We retrospectively reviewed 28 obese and morbidly obese patients who presented from December 2007 through July 2013 with large or recurrent type 3 or 4 paraesophageal hernia...
July 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Vincent Nguyen, Hannah Vassaur, F Paul Buckley
Chylous ascites is an accumulation of milky lipid-rich lymph in the peritoneal cavity. Spontaneous chyle leak is a rare occurrence, often associated with malignancy or cirrhosis. This is a report of spontaneous chylous ascites, chylomediastinum and chylothoraces encountered in the setting of an incarcerated paraesophageal hernia. A 60-year-old female presented to the emergency department with epigastric pain, dysphagia and vomiting. Clinical presentation and imaging were concerning for an incarcerated paraesophageal hernia, and the patient was taken to the operating room...
2015: Journal of Surgical Case Reports
Beat P Müller-Stich, Hannes G Kenngott, Matthias Gondan, Christian Stock, Georg R Linke, Franziska Fritz, Felix Nickel, Markus K Diener, Carsten N Gutt, Moritz Wente, Markus W Büchler, Lars Fischer
INTRODUCTION: Mesh augmentation seems to reduce recurrences following laparoscopic paraesophageal hernia repair (LPHR). However, there is an uncertain risk of mesh-associated complications. Risk-benefit analysis might solve the dilemma. MATERIALS AND METHODS: A systematic literature search was performed to identify randomized controlled trials (RCTs) and observational clinical studies (OCSs) comparing laparoscopic mesh-augmented hiatoplasty (LMAH) with laparoscopic mesh-free hiatoplasty (LH) with regard to recurrences and complications...
2015: PloS One
Toms Augustin, Eric Schneider, Diya Alaedeen, Matthew Kroh, Ali Aminian, David Reznick, Matthew Walsh, Stacy Brethauer
AIM: Patients undergoing emergency surgery for paraesophageal hernia (PEH) repair have a higher adjusted mortality risk based on Nationwide Inpatient Sample (NIS). We sought to examine this relationship in the National Surgical Quality Improvement Program (NSQIP), which adjusts for patient-level risk factors, including factors contributing to patient frailty. METHODS: This is a retrospective analysis of the NSQIP from 2009 through 2011. A modified frailty index was created based on previously validated methodology...
December 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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