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Journal of Gastrointestinal Surgery

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01-01-2017 | 2016 SSAT Plenary Presentation

A Combined Nissen Plus Hill Hybrid Repair for Paraesophageal Hernia Improves Clinical Outcomes and Reduces Long-Term Recurrences Compared with Laparoscopic Nissen Alone

Authors: Gal Levy, Ralph W. Aye, Alexander S. Farivar, Brian E. Louie

Published in: Journal of Gastrointestinal Surgery | Issue 1/2017

Abstract

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.

Results

With 319 repairs (HYB = 141, LNF = 178), the groups were comparable in age and gender, but HYB had a higher BMI (30.95 vs 29.27, p < 0.05), larger hernia (6 vs 5 cm, p < 0.05), and more Barrett’s esophagus (42 vs 29, p < 0.05). At a median follow-up of 22 months, DeMeester scores were equivalent but PPI use was higher in the LNF group. All three quality of life scores were better for HYB: GERD-HRQL 3.75 vs 7.49, p = 0.01; QOLRAD 6.59 vs 6.23, p = 0.04; and swallowing 40.71 vs 36.47, p = 0.01. At a median follow-up of 60 months (HYB = 39, LNF = 31), anatomic recurrences and reoperations were lower for HYB: 5 vs 45 % (p < 0.05), 2.6 vs 9.7 % (p = 0.2).

Conclusion

Combining Nissen and Hill for PEH repair appears to result in better quality of life and fewer recurrences compared to LNF.

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Title: A Combined Nissen Plus Hill Hybrid Repair for Paraesophageal Hernia Improves Clinical Outcomes and Reduces Long-Term Recurrences Compared with Laparoscopic Nissen Alone
Authors: Gal Levy
Ralph W. Aye
Alexander S. Farivar
Brian E. Louie
Publication date: 01-01-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 1/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-016-3225-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Combined Nissen Plus Hill Hybrid Repair for Paraesophageal Hernia Improves Clinical Outcomes and Reduces Long-Term Recurrences Compared with Laparoscopic Nissen Alone

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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