Laparoscopic Paraesophageal Hernia Repair: Defining Long-Term Clinical and Anatomic Outcomes

Brant K. Oelschlager, Rebecca P. Petersen, L. Michael Brunt, Nathaniel J. Soper, Brett C. Sheppard, Lee Mitsumori, Charles Rohrmann, Lee L. Swanstrom, Carlos A. Pellegrini

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)453-459
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume16
Issue number3
DOIs
StatePublished - Mar 1 2012

Keywords

  • Laparoscopic paraesophageal hernia
  • Long-term clinical outcomes
  • Recurrence rate

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Oelschlager, B. K., Petersen, R. P., Brunt, L. M., Soper, N. J., Sheppard, B. C., Mitsumori, L., Rohrmann, C., Swanstrom, L. L., & Pellegrini, C. A. (2012). Laparoscopic Paraesophageal Hernia Repair: Defining Long-Term Clinical and Anatomic Outcomes. Journal of Gastrointestinal Surgery, 16(3), 453-459. https://doi.org/10.1007/s11605-011-1743-z