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01-12-2008 | 2008 ssat plenary presentation

Laparoscopic Repair of Giant Paraesophageal Hernia Results in Long-Term Patient Satisfaction and a Durable Repair

Authors: Katie S. Nason, James D. Luketich, Irfan Qureshi, Samuel Keeley, Shannon Trainor, Omar Awais, Manisha Shende, Rodney J. Landreneau, Blair A. Jobe, Arjun Pennathur

Published in: Journal of Gastrointestinal Surgery | Issue 12/2008

Abstract

Background

Laparoscopic repair of giant paraesophageal hernia (LRGPEH) is routinely performed in many centers, but high recurrence rates have led to concerns regarding this approach. We evaluate long-term recurrence rates, symptom improvement and correlation with radiographic recurrence, and risk factors for recurrence in our cohort of patients.

Methods

A cohort of consecutive patients with a minimum of 5 years potential follow-up (1997–2003) post-LRGPEH was identified from a prospective database. Clinical outcomes, barium esophagram (BE), and quality-of-life (QoL) measures were obtained.

Results

Laparoscopic repair was successful in 185/187 patients. Routine clinical follow-up (median 77 months) was available for all patients. Detailed questionnaires and BE were obtained in 65% and 82% of patients. Gastroesophageal Reflux Disease Health-Related QoL (GERD-HRQoL) scores were excellent to good in 86.7%. BE (median 51 months) demonstrated radiographic hernia recurrence in 15% of patients, but without consistent symptom association. There was a trend toward increased risk of radiographic recurrence in patients with a history of pulmonary disease (p = 0.08). Seven reoperations (4.4%) were performed for symptomatic recurrence (median 44 months postoperative).

Conclusions

LRGPEH performed in our minimally invasive center of excellence resulted in a durable repair with a high degree of satisfaction and preservation of GERD-related QoL at a median follow-up of over 6 years.

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Title: Laparoscopic Repair of Giant Paraesophageal Hernia Results in Long-Term Patient Satisfaction and a Durable Repair
Authors: Katie S. Nason
James D. Luketich
Irfan Qureshi
Samuel Keeley
Shannon Trainor
Omar Awais
Manisha Shende
Rodney J. Landreneau
Blair A. Jobe
Arjun Pennathur
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 12/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0712-7

At a glance: The STEP trials

Springer Medicine

Laparoscopic Repair of Giant Paraesophageal Hernia Results in Long-Term Patient Satisfaction and a Durable Repair

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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