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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
#1
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...
June 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28594583/impact-of-surgeon-specialty-on-perioperative-outcomes-of-surgery-for-benign-esophageal-diseases-a-nsqip-analysis
#2
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
#3
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/28493161/primary-versus-redo-paraesophageal-hiatal-hernia-repair-a-comparative-analysis-of-operative-and-quality-of-life-outcomes
#4
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
#5
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
#6
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
#7
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/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
#8
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
https://www.readbyqxmd.com/read/28106744/oligonucleotide-therapy-for-obstructive-and-restrictive-respiratory-diseases
#9
REVIEW
Wupeng Liao, Jinrui Dong, Hong Yong Peh, Lay Hong Tan, Kah Suan Lim, Li Li, Wai-Shiu Fred Wong
Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD) and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF). The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology...
January 17, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28063123/minimally-invasive-surgery-should-be-the-standard-of-care-for-paraesophageal-hernia-repair
#10
Francisco Schlottmann, Paula D Strassle, Timothy M Farrell, Marco G Patti
BACKGROUND: It is unclear if minimally invasive surgery (MIS) has been universally embraced for paraesophageal hernia (PEH) repair. The aims of this study were: (a) to assess the national utilization of MIS for PEH repair and (b) to compare the perioperative outcomes between MIS and open procedures 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...
May 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27699515/a-5-item-frailty-index-based-on-nsqip-data-correlates-with-outcomes-following-paraesophageal-hernia-repair
#11
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...
June 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27595155/the-optimal-approach-to-symptomatic-paraesophageal-hernia-repair-important-technical-considerations
#12
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
#13
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...
January 2017: 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
#14
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
#15
REVIEW
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
#16
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
#17
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
#18
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/para-oesophageal-and-parahiatal-hernias-in-an-asian-acute-care-tertiary-hospital-an-underappreciated-surgical-condition
#19
Ye Xin Koh, Lester Wei Lin Ong, June Lee, Andrew Siang Yih Wong
INTRODUCTION: The prevalence of hiatal hernias and para-oesophageal hernias (PEHs) is lower in Asian populations than in Western populations. Progressive herniation can result in giant PEHs, which are 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...
December 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/26659229/revisional-paraesophageal-hernia-repair-outcomes-compare-favorably-to-initial-operations
#20
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
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