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https://www.readbyqxmd.com/read/28976874/paraesophageal-hernia-as-a-cause-of-chronic-asymptomatic-anemia-in-a-6-years-old-boy-case-report-and-review-of-the-literature
#1
Dimitrios Patoulias, Maria Kalogirou, Thomas Feidantsis, Ignatios Kallergis, Ioannis Patoulias
Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia...
2017: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/28869165/concurrent-bariatric-surgery-and-paraesophageal-hernia-repair-comparison-of-sleeve-gastrectomy-and-roux-en-y-gastric-bypass
#2
Amber L Shada, Miloslawa Stem, Luke M Funk, Jacob A Greenberg, Anne O Lidor
BACKGROUND: Paraesophageal hernia (PEH) is a common condition that bariatric surgeons encounter. Expert opinion is split on whether bariatric surgery and PEH repair should be completed concurrently or sequentially. We hypothesized that concurrent bariatric surgery and PEH repair is safe. OBJECTIVES: We examined 30-day outcomes after concomitant PEH repair and bariatric surgery. SETTING: National database, United States. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database (2011-2014), we identified patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) with or without PEH repair...
July 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28840522/endoscopic-evaluation-of-post-fundoplication-anatomy
#3
REVIEW
Walaa F Abdelmoaty, Lee L Swanstrom
PURPOSE OF REVIEW: We aim to review the endoscopic evaluation of post-fundoplication anatomy and its role in assessment of fundoplication outcomes and in pre-operative planning for reoperation in failed procedures. RECENT FINDINGS: There is no universally accepted system for evaluating post-fundoplication anatomy endoscopically. However, multiple reports described the usefulness of post-operative endoscopy as a quality control measure and in the evaluation of complex cases such as repeat procedures and paraesophageal hernias (PEH)...
August 24, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28826953/mesh-cruroplasty-in-laparoscopic-repair-of-paraesophageal-hernias%C3%A2-is%C3%A2-not-associated-with-better-long-term-outcomes-compared%C3%A2-to%C3%A2-primary-repair
#4
Vernissia Tam, James D Luketich, Ryan M Levy, Neil A Christie, Omar Awais, Manisha Shende, Katie S Nason
BACKGROUND: Equipoise still exists regarding routine mesh cruroplasty during laparoscopic paraesophageal hernia (PEH). We aimed to determine whether selective mesh cruroplasty is associated with differences in recurrence and patient-reported outcomes. METHODS: We compared symptom outcomes (n = 688) and radiographic recurrences (n = 101; at least 10% [or 2 cm] of stomach above hiatus) for 795 non-emergent PEH repair with fundoplication (n = 106 with mesh)...
October 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28733735/laparoscopic-repair-of-giant-paraesophageal-hernia-are-there-factors-associated-with-anatomic-recurrence
#5
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/28608040/paraesophageal-hernia-repair-in-the-usa-trends-of-utilization-stratified-by-surgical-volume-and-consequent-impact-on-perioperative-outcomes
#6
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/28594583/impact-of-surgeon-specialty-on-perioperative-outcomes-of-surgery-for-benign-esophageal-diseases-a-nsqip-analysis
#7
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)...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28550872/hiatal-and-paraesophageal-hernia-repair-in-pediatric-patients
#8
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
#9
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
#10
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
#11
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
#12
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/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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
March 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27398823/surgical-treatment-of-paraesophageal-hernias-a-review
#20
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
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