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Journal of Gastrointestinal Surgery

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01-11-2015 | Original Article

Symptom Relief After Laparoscopic Paraesophageal Hernia Repair Without Mesh

Authors: Rym El Khoury, Mauricio Ramirez, Eric S. Hungness, Nathaniel J. Soper, Marco G. Patti

Published in: Journal of Gastrointestinal Surgery | Issue 11/2015

Abstract

Background

Laparoscopic repair of paraesophageal hernia (LPEHR) is considered today the standard of care for this condition. While attention has been mostly focused on the incidence of postoperative radiologic recurrence of a hiatal hernia, few data are available about the effect of the operation on symptoms.

Aims

In this study, we aim to determine the effect of primary LPEHR on postoperative symptoms.

Patients and Methods

One hundred and sixty-two patients underwent LPEH repair in two academic tertiary care centers. Preoperative evaluation included barium swallow (100 %), endoscopy (80 %), manometry (81 %), and pH monitoring (25 %). Type III PEH was the most common (94 %), and it was associated with a gastric volvulus in 27 % of patients.

Results

A fundoplication was performed in all patients: Nissen in 57 %, Dor in 36 %, and Toupet in 6 %. A Collis gastroplasty was added in 6 % of patients. There were no perioperative deaths. The intraoperative complication rate was 7 %. The operation was completed laparoscopically in 98 % of patients. Postoperative complications occurred in four patients, and three needed a second operation. Average follow-up was 24 months. Heartburn, regurgitation, chest pain, dysphagia, respiratory symptoms, and hoarseness improved as a result of the operation. Anemia fully resolved in all patients.

Conclusions

LPEH repair is safe and effective, and the need for reoperation is rare. Few patients experience postoperative symptoms, and these are easily controlled with acid-reducing medications.

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Title: Symptom Relief After Laparoscopic Paraesophageal Hernia Repair Without Mesh
Authors: Rym El Khoury
Mauricio Ramirez
Eric S. Hungness
Nathaniel J. Soper
Marco G. Patti
Publication date: 01-11-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 11/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2904-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Symptom Relief After Laparoscopic Paraesophageal Hernia Repair Without Mesh

Abstract

Background

Aims

Patients and Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Aims

Patients and Methods

Results

Conclusions

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