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Journal of Gastrointestinal Surgery

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01-03-2018 | Original Article

A Hill Gastropexy Combined with Nissen Fundoplication Appears Equivalent to a Collis-Nissen in the Management of Short Esophagus

Authors: Oliver C. Bellevue, Brian E. Louie, Zeljka Jutric, Alexander S. Farivar, Ralph W. Aye

Published in: Journal of Gastrointestinal Surgery | Issue 3/2018

Abstract

Introduction

A Collis gastroplasty combined with a Nissen fundoplication is commonly used when a shortened esophagus is encountered. An alternative combines intra-abdominal fixation of the gastroesophageal junction via a Hill gastropexy with a Nissen fundoplication to maintain length and avoid juxtaposing acid-secreting tissue against the diseased esophagus.

Methods

A retrospective case-controlled analysis of 106 consecutive patients with short esophagus undergoing Hill-Nissen (HN) or Collis-Nissen (CN) was compared to a cohort of 105 matched patients without short esophagus undergoing primary Nissen fundoplication (NF).

Results

At a median follow-up of 27 months, all groups (HN:CN:NF) improved significantly over preoperative baseline with no differences in overall complications (18 vs 16 vs 19%, p = 0.78), DeMeester score (11.1 vs 19.1 vs 14.2, p = 0.49), postoperative PPI use (16 vs 22 vs 15%, p = 0.24), anatomic recurrences (11.7 vs 5.5 vs 7%, p = 0.43), or quality of life (6.8 vs 6.7 vs 6.4, p = 0.3).

Conclusions

The management of shortened esophagus with Hill-Nissen is safe and as effective as Collis gastroplasty with Nissen fundoplication. Both options appear to produce similar outcomes to patients requiring only a Nissen fundoplication suggesting a shortened esophagus does not beget an inferior outcome.

Attwood SE, Lundell L, Ell C, Galmiche JP, Hatlebakk J, Fiocca R, Lind T, Eklund S, Junghard O; LOTUS Trial Group. Standardization of surgical technique in antireflux surgery: the LOTUS Trial experience. World J Surg. 2008 Jun;32(6):995–8.

Patti MG, Allaix ME, Fisichella PM. Analysis of the Causes of Failed Antireflux Surgery and the Principles of Treatment: A Review. JAMA Surg. 2015 Jun;150(6):585–90.CrossRefPubMed

Low DE. The short esophagus-recognition and management. J Gastrointest Surg. 2001 Sep-Oct;5(5):458–61.CrossRefPubMed

Nason KS, Luketich JD, Awais O, Abbas G, Pennathur A, Landreneau RJ, Schuchert MJ. Quality of life after Collis gastroplasty for short esophagus in patients with paraesophageal hernia. Ann Thorac Surg. 2011 Nov;92(5):1854–60; discussion 1860–1.

Mattioli S, Lugaresi ML, Costantini M, Del Genio A, Di Martino N, Fei L, Fumagalli U, Maffettone V, Monaco L, Morino M, Rebecchi F, Rosati R, Rossi M, Santi S, Trapani V, Zaninotto G. The short esophagus: intraoperative assessment of esophageal length. J Thorac Cardiovasc Surg. 2008 Oct;136(4):834–41.CrossRefPubMed

Oelschlager BK, Yamamoto K, Woltman T, Pellegrini C. Vagotomy during hiatal hernia repair: a benign esophageal lengthening procedure. J Gastrointest Surg. 2008 Jul;12(7):1155–62.CrossRefPubMed

Collis Jl. An operation for hiatus hernia with short esophagus. J Thorac Surg. 1957 Dec;34(6):768–73; discussion 774–8.

Jobe BA, Aye RW, Deveney CW, Domreis JS, Hill LD. Laparoscopic management of giant type III hiatal hernia and short esophagus. Objective follow-up at three years. J Gastrointest Surg. 2002 Mar-Apr;6(2):181–8; discussion 188.

Qureshi AP, Aye RW, Buduhan G, Knight A, Orlina J, Farivar AS, Wagner OJ, McHugh S, Louie BE. The laparoscopic Nissen-Hill hybrid: pilot study of a combined antireflux procedure. Surg Endosc. 2013 Jun;27(6):1945–52.CrossRefPubMed

10.

Aye RW, Qureshi AP, Wilshire CL, Farivar AS, Vallières E, Louie BE. Feasibility, safety, and short-term efficacy of the laparoscopic Nissen-Hill hybrid repair. Surg Endosc. 2016 Feb;30(2):551–8.CrossRefPubMed

11.

Levy G, Aye RW, Farivar AS, Louie BE. A Combined Nissen Plus Hill Hybrid Repair for Paraesophageal Hernia Improves Clinical Outcomes and Reduces Long-term Recurrences Compared with Laparoscopic Nissen Alone. J Gastrointest Surg. 2017 Jan;21(1):121–125.CrossRefPubMed

12.

Pearson FG, Cooper JD, Patterson GA, Ramirez J, Todd TR. Gastroplasty and fundoplication for complex reflux problems. Long-term results. Ann Surg. 1987 Oct;206(4):473–81.CrossRefPubMedPubMedCentral

13.

Seely AJ, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, Gilbert S, Maziak DE, Shamji FM, Sundaresan RS. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010 Sep;90(3):936–42; discussion 942.

14.

Velanovich V. The development of the GERD-HRQL symptom severity instrument. Dis Esophagus. 2007;20(2):130–4.CrossRefPubMed

15.

Wiklund IK, Junghard O, Grace E, et al. Quality of Life in Reflux and Dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD). Eur J Surg Suppl. 1998;(583):41–9.

16.

Dakkak M, Bennett JR. A new dysphagia score with objective validation. J Clin Gastroenterol. 1992 Mar;14(2):99–100.CrossRefPubMed

17.

Aye R. The Hill procedure for gastroesophageal reflux. In: Current therapy in thoracic and cardiovascular surgery. St Louis, MO: Mosby-Year Book, 2001.

18.

Terry ML, Vernon A, Hunter JG. Stapled-wedge Collis gastroplasty for the shortened esophagus. Am J Surg. 2004 Aug;188(2):195–9.CrossRefPubMed

19.

Wilson JL, Bradley DD, Louie BE, Aye RW, Vallières E, Farivar AS. Laparoscopy with left chest collis gastroplasty: a simplified technique for shortened esophagus. Ann Thorac Surg. 2014 Nov;98(5):1860–2.CrossRefPubMed

20.

Lugaresi M, Mattioli B, Perrone O, Daddi N, Di Simone MP, Mattioli S. Results of left thoracoscopic Collis gastroplasty with laparoscopic Nissen fundoplication for the surgical treatment of true short oesophagus in gastro-oesophageal reflux disease and Type III–IV hiatal hernia. Eur J Cardiothorac Surg 2016;49:e22–e30.CrossRefPubMed

21.

Lidor AO, Steele KE, Stem M, Fleming RM, Schweitzer MA, Marohn MR. Long-term quality of life and risk factors for recurrence after laparoscopic repair of paraesophageal hernia. JAMA Surg. 2015 May;150(5):424–31.CrossRefPubMed

22.

Oelschlager BK, Pellegrini CA, Hunter JG, Brunt ML, Soper NJ, Sheppard BC, Polissar NL, Neradilek MB, Mitsumori LM, Rohrmann CA, Swanstrom LL. Biologic prosthesis to prevent recurrence after laparoscopic paraesophageal hernia repair: long-term follow-up from a multicenter, prospective, randomized trial. J Am Coll Surg. 2011 Oct;213(4):461–8.CrossRefPubMed

23.

Dallemagne B, Kohnen L, Perretta S, Weerts J, Markiewicz S, Jehaes C. Laparoscopic repair of paraesophageal hernia. Long-term follow-up reveals good clinical outcome despite high radiological recurrence rate. Ann Surg. 2011 Feb;253(2):291–6.CrossRefPubMed

24.

Maziak DE, Todd TR, Pearson FG. Massive hiatus hernia: evaluation and surgical management. J Thorac Cardiovasc Surg. 1998 Jan;115(1):53–60; discussion 61–2.

25.

Youssef YK, Shekar N, Lutfi R, Richards WO, Torquati A. Long-term evaluation of patient satisfaction and reflux symptoms after laparoscopic fundoplication with Collis gastroplasty. Surg Endosc. 2006 Nov;20(11):1702–5.CrossRefPubMed

Title: A Hill Gastropexy Combined with Nissen Fundoplication Appears Equivalent to a Collis-Nissen in the Management of Short Esophagus
Authors: Oliver C. Bellevue
Brian E. Louie
Zeljka Jutric
Alexander S. Farivar
Ralph W. Aye
Publication date: 01-03-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 3/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3598-4

At a glance: The STEP trials

Springer Medicine

A Hill Gastropexy Combined with Nissen Fundoplication Appears Equivalent to a Collis-Nissen in the Management of Short Esophagus

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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