TY - JOUR
T1 - Laparoscopic Paraesophageal Hernia Repair
T2 - Defining Long-Term Clinical and Anatomic Outcomes
AU - Oelschlager, Brant K.
AU - Petersen, Rebecca P.
AU - Brunt, L. Michael
AU - Soper, Nathaniel J.
AU - Sheppard, Brett C.
AU - Mitsumori, Lee
AU - Rohrmann, Charles
AU - Swanstrom, Lee L.
AU - Pellegrini, Carlos A.
N1 - Funding Information:
Acknowledgments This work was supported in part by Cook Biotech, the Mary and Dennis Wise Fund, and the Byers Endowed Professorship, University of Washington.
PY - 2012/3
Y1 - 2012/3
N2 - Objective: We recently reported in a multi-institutional, randomized study of laparoscopic paraesophageal hernia repair (LPEHR) that the anatomic recurrence rate at a median of approximately 5 years was >50%. This study focuses exclusively on the symptomatic response to LPEHR and its relationship with the development of a recurrent hernia. Methods: During 2002 to 2005, 108 patients underwent LPHER with or without biologic mesh. A standardized symptom severity questionnaire, SF-36 health survey, and upper gastrointestinal series were performed at baseline, 6 months, and during 2008-2009. Results: Of 108 patients, 72 (average age of 68 ± 10 years) underwent clinical assessment, and 60 of them also had radiologic studies at a median follow-up of 58 (40-78) months. Radiographic recurrence (≥20 mm) was 14% at 6 months and 57% at the time of follow-up, and the average recurrence size was 40 ± 10 mm. All symptoms were significantly improved at long-term follow-up and, with the exception of heartburn, were unaffected by the presence or size of the recurrence. Two patients (3%) with recurrent symptoms related to their hernia underwent reoperation. Conclusion: Despite frequent radiologic recurrences after LPEHR, symptoms remain well controlled, patient satisfaction is high, and the need for reoperation is low.
AB - Objective: We recently reported in a multi-institutional, randomized study of laparoscopic paraesophageal hernia repair (LPEHR) that the anatomic recurrence rate at a median of approximately 5 years was >50%. This study focuses exclusively on the symptomatic response to LPEHR and its relationship with the development of a recurrent hernia. Methods: During 2002 to 2005, 108 patients underwent LPHER with or without biologic mesh. A standardized symptom severity questionnaire, SF-36 health survey, and upper gastrointestinal series were performed at baseline, 6 months, and during 2008-2009. Results: Of 108 patients, 72 (average age of 68 ± 10 years) underwent clinical assessment, and 60 of them also had radiologic studies at a median follow-up of 58 (40-78) months. Radiographic recurrence (≥20 mm) was 14% at 6 months and 57% at the time of follow-up, and the average recurrence size was 40 ± 10 mm. All symptoms were significantly improved at long-term follow-up and, with the exception of heartburn, were unaffected by the presence or size of the recurrence. Two patients (3%) with recurrent symptoms related to their hernia underwent reoperation. Conclusion: Despite frequent radiologic recurrences after LPEHR, symptoms remain well controlled, patient satisfaction is high, and the need for reoperation is low.
KW - Laparoscopic paraesophageal hernia
KW - Long-term clinical outcomes
KW - Recurrence rate
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U2 - 10.1007/s11605-011-1743-z
DO - 10.1007/s11605-011-1743-z
M3 - Article
C2 - 22215243
AN - SCOPUS:84856729943
SN - 1091-255X
VL - 16
SP - 453
EP - 459
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 3
ER -