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https://www.readbyqxmd.com/read/27699515/a-5-item-frailty-index-based-on-nsqip-data-correlates-with-outcomes-following-paraesophageal-hernia-repair
#1
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
https://www.readbyqxmd.com/read/27595155/the-optimal-approach-to-symptomatic-paraesophageal-hernia-repair-important-technical-considerations
#2
REVIEW
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
https://www.readbyqxmd.com/read/27492354/a-combined-nissen-plus-hill-hybrid-repair-for-paraesophageal-hernia-improves-clinical-outcomes-and-reduces-long-term-recurrences-compared-with-laparoscopic-nissen-alone
#3
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
https://www.readbyqxmd.com/read/27422243/laparoscopic-paraesophageal-hernia-repair-is-safe-in-elderly-patients
#4
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
https://www.readbyqxmd.com/read/27398823/surgical-treatment-of-paraesophageal-hernias-a-review
#5
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.
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27229099/the-impact-of-frailty-on-outcomes-of-paraesophageal-hernia-repair
#6
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
https://www.readbyqxmd.com/read/27157131/house-dust-mite-induced-asthma-causes-oxidative-damage-and-dna-double-strand-breaks-in-the-lungs
#7
Tze Khee Chan, Xin Yi Loh, Hong Yong Peh, W N Felicia Tan, W S Daniel Tan, Na Li, Ian J J Tay, W S Fred Wong, Bevin P Engelward
BACKGROUND: Asthma is related to airway inflammation and oxidative stress. High levels of reactive oxygen and nitrogen species can induce cytotoxic DNA damage. Nevertheless, little is known about the possible role of allergen-induced DNA damage and DNA repair as modulators of asthma-associated pathology. OBJECTIVE: We sought to study DNA damage and DNA damage responses induced by house dust mite (HDM) in vivo and in vitro. METHODS: We measured DNA double-strand breaks (DSBs), DNA repair proteins, and apoptosis in an HDM-induced allergic asthma model and in lung samples from asthmatic patients...
July 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27035739/robotic-assisted-paraesophageal-hernia-repair-initial-experience-at-a-single-institution
#8
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
https://www.readbyqxmd.com/read/26778633/paraesophageal-and-parahiatal-hernias-in-an-asian-acute-care-tertiary-hospital-an-underappreciated-surgical-condition
#9
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
https://www.readbyqxmd.com/read/26659229/revisional-paraesophageal-hernia-repair-outcomes-compare-favorably-to-initial-operations
#10
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
https://www.readbyqxmd.com/read/26553416/dental-stem-cells-a-future-asset-of-ocular-cell-therapy
#11
REVIEW
Gary Hin-Fai Yam, Gary Swee-Lim Peh, Shweta Singhal, Bee-Tin Goh, Jodhbir S Mehta
Regenerative medicine using patient's own stem cells (SCs) to repair dysfunctional tissues is an attractive approach to complement surgical and pharmacological treatments for aging and degenerative disorders. Recently, dental SCs have drawn much attention owing to their accessibility, plasticity and applicability for regenerative use not only for dental, but also other body tissues. In ophthalmology, there has been increasing interest to differentiate dental pulp SC and periodontal ligament SC (PDLSC) towards ocular lineage...
2015: Expert Reviews in Molecular Medicine
https://www.readbyqxmd.com/read/26467561/emergent-surgery-does-not-independently-predict-30-day-mortality-after-paraesophageal-hernia-repair-results-from-the-acs-nsqip-database
#12
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
https://www.readbyqxmd.com/read/26242885/symptom-relief-after-laparoscopic-paraesophageal-hernia-repair-without-mesh
#13
Rym El Khoury, Mauricio Ramirez, Eric S Hungness, Nathaniel J Soper, Marco G Patti
BACKGROUND: Laparoscopic repair of paraesophageal hernia (LPEHR) is considered today the standard of care for this condition. While attention has been mostly focused on the incidence of postoperative radiologic recurrence of a hiatal hernia, few data are available about the effect of the operation on symptoms. AIMS: In this study, we aim to determine the effect of primary LPEHR on postoperative symptoms. PATIENTS AND METHODS: One hundred and sixty-two patients underwent LPEH repair in two academic tertiary care centers...
November 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/26194263/paraesophageal-hernia-repair-in-the-emergency-setting-is-laparoscopy-with-the-addition-of-a-fundoplication-the-new-gold-standard
#14
Michael Klinginsmith, Jennifer Jolley, Daniel Lomelin, Crystal Krause, Jace Heiden, Dmitry Oleynikov
BACKGROUND: Laparoscopic repair of paraesophageal hernia (PEH) with fundoplication is currently the preferred elective strategy, but emergent cases are often done open without an anti-reflux (AR) procedure. This study examined PEH repair in elective and urgent/emergent settings and investigated patient characteristic influence on the use of adjunctive techniques, such as AR procedures or gastrostomy tube (GT) placement. METHODS: Utilizing the University HealthSystem Consortium Clinical Database Resource Manager, selected discharge data were retrieved using International Classification of Disease 9 diagnosis codes for PEH and procedure specific codes...
May 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26081111/short-term-results-of-laparoscopic-sleeve-gastrectomy-in-combination-with-hiatal-hernia-repair-experience-in-a-single-accredited-center
#15
Maher El Chaar, George Ezeji, Leonardo Claros, Maureen Miletics, Jill Stoltzfus
BACKGROUND: Laparoscopic sleeve gastrectomy (SG), while generally safe and efficacious, may be complicated by gastroesophageal reflux disease (GERD) symptoms as well as the need for hiatus hernia (HH) repair. Identification and management of HH during SG and the effect of HH repair on GERD-related symptoms following SG are controversial. OBJECTIVE: This study aimed to evaluate HH repair during SG in morbidly obese patients and its short-term effect on GERD-related symptoms and other clinical outcomes...
January 2016: Obesity Surgery
https://www.readbyqxmd.com/read/26065538/feasibility-safety-and-short-term-efficacy-of-the-laparoscopic-nissen-hill-hybrid-repair
#16
Ralph W Aye, Alia P Qureshi, Candice L Wilshire, Alexander S Farivar, Eric Vallières, Brian E Louie
BACKGROUND: A novel antireflux procedure combining laparoscopic Nissen fundoplication and Hill repair components was tested in 50 patients with paraesophageal hernia (PEH) and/or Barrett's esophagus (BE) because these two groups have been found to have a high rate of recurrence with conventional repairs. METHODS: Patients with symptomatic PEH and/or non-dysplastic BE underwent repair. Quality of life (QOL) metrics, manometry, EGD, and pH testing were administered pre- and postoperatively...
February 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/25965129/paraesophageal-hernia
#17
REVIEW
Dmitry Oleynikov, Jennifer M Jolley
The treatment of PEHs is challenging. They tend to occur in patients in their 60s and 70s with multiple medical problems and a variety of associated symptoms. Detailed preoperative evaluation is crucial to determining a safe and effective strategy for repair in the operating room. Laparoscopic PEH repair has shown to be advantageous compared with conventional open repair with regard to hospital stay, recovery time, and decreased complications. Although some results indicate there are higher recurrence rates in laparoscopic PEH repair, the clinical significance of these recurrences has not yet been determined...
June 2015: Surgical Clinics of North America
https://www.readbyqxmd.com/read/25868406/repair-of-paraesophageal-hiatal-hernias%C3%A2-is-a-fundoplication-needed-a-randomized-controlled-pilot-trial
#18
RANDOMIZED CONTROLLED TRIAL
Beat P Müller-Stich, Verena Achtstätter, Markus K Diener, Matthias Gondan, René Warschkow, Francesco Marra, Andreas Zerz, Carsten N Gutt, Markus W Büchler, Georg R Linke
BACKGROUND: The need for a fundoplication during repair of paraesophageal hiatal hernias (PEH) remains unclear. Prevention of gastroesophageal reflux represents a trade-off against the risk of fundoplication-related side effects. The aim of this trial was to compare laparoscopic mesh-augmented hiatoplasty with simple cardiophrenicopexy (LMAH-C) with laparoscopic mesh-augmented hiatoplasty with fundoplication (LMAH-F) in patients with PEH. STUDY DESIGN: The study was designed as a patient- and assessor-blinded randomized controlled pilot trial, registration number: DRKS00004492 (www...
August 2015: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/25849293/the-use-of-autologous-fascia-lata-graft-in-the-laparoscopic-reinforcement-of-large-hiatal-defect-initial-observations-of-the-surgical-technique
#19
Milos Bjelovic, Tamara Babic, Bratislav Spica, Dragan Gunjic, Milan Veselinovic, Violeta Bascarevic
BACKGROUND: Even though there is no consensus, many authors believe that in the cases of large hiatal defects, structurally altered crura and/or absence of peritoneal lining, a crural reinforcement should be performed. Reinforcement could be performed with different techniques and different type of mesh, either synthetic or biologic. The disadvantages of mesh repair include the possibility of serious complications and increased costs especially in the usage of composite or biologic mesh...
2015: BMC Surgery
https://www.readbyqxmd.com/read/25788120/laparoscopic-repair-of-paraesophageal-hernias-with-a-falciform-ligament-buttress
#20
Raymond Laird, Fred Brody, Jeffrey N Harr, Nathan G Richards, Steve Zeddun
BACKGROUND: Buttressing the crura in paraesophageal hernia (PEH) repairs with synthetic mesh may be associated with erosions and dysphagia, while biologic buttresses are expensive and do not decrease long-term recurrence rates. This study documents outcomes following laparoscopic PEH repairs using the falciform ligament as a buttress. METHODS: This is a prospective study of laparoscopic PEH repairs with a falciform ligament buttress. Preoperatively and at 6 months follow-up, medications, radiologic studies and symptom scores were recorded...
July 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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