P6 HIATAL HERNIA REPAIR BY TENSION-FREE MESH CLOSURE OR SIMPLE SUTURING OF THE DIAPHRAGMATIC HIATUS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Analatos Apostolos ◽  
Håkanson Bengt ◽  
Lundell Lars ◽  
Lindblad Mats ◽  
Thorell Anders
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Esophageal Reflux ◽  
Recurrence Rates ◽  
Tension Free ◽  
Absorbable Mesh ◽  
Recurrent Hiatal Hernia

Abstract Aim To assess the anatomical and functional results of the use of a mesh for the repairing of hiatal hernia in patients with gastro-esophageal reflux disease (GERD) Background & Methods In hiatal hernia repair during antireflux surgery, less focus has traditionally been directed towards the restoration of the diaphragmatic hiatus. In other types of hernia repair, the use of a mesh-reinforced, tension-free technique has been shown to be associated with reduced recurrence rates. Patients (n=159) undergoing Nissen fundoplication for gastro-esophageal reflux disease were randomized to closure of the diaphragmatic hiatus with either crural sutures alone (n=77) or tension-free closure with a non-absorbable mesh (Crurasoft®, n=82). Primary outcome was radiologically verified recurrent hiatal hernia. Secondary outcomes were intra-and postoperative complications and courses, symptomatic recurrence, use of PPI, postoperative oesophageal acid exposure and Quality of Life. Results At 3 years recurrence rates were 12 % and 9 % in the mesh and suture groups respectively (p=0,61). Control of GERD symptoms, use of PPI and oesophageal acid exposure did not differ between groups. At the same time obstructive eating complaints were reduced in both groups compared to the preoperative setting (p<0.05) but more patients scored dysphagia for solid food after mesh closure (p=0,027). Quality of life scores were significantly improved throughout the follow up without differences between groups. Conclusion Tension-free crural repair with non-absorbable mesh does not reduce the incidence of recurrent hiatal hernia compared to crural sutures alone in GERD patients undergoing total fundoplication. This, together with the finding of increased dysphagia at 3 years postoperatively, suggests that mesh closure cannot be recommended for routine use in laparoscopic hiatal hernia repair for GERD.

Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

2019 ◽  
Vol 34 (7) ◽  
pp. 3072-3078 ◽  
Author(s):  
Alex Addo ◽  
Andrew Broda ◽  
H. Reza Zahiri ◽  
Ian M. Brooks ◽  
Adrian Park
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

Primary versus redo paraesophageal hiatal hernia repair: a comparative analysis of operative and quality of life outcomes

2017 ◽  
Vol 31 (12) ◽  
pp. 5166-5174 ◽  
Author(s):  
H. Reza Zahiri ◽  
Adam S. Weltz ◽  
Udai S. Sibia ◽  
Neethi Paranji ◽  
Steven D. Leydorf ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Paraesophageal Hiatal Hernia

RA06.03: SURGICAL OUTCOMES OF GIANT HIATAL HERNIA REPAIR IN PATIENTS OVER THE AGE OF 80

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 30-30
Author(s):  
Oleksandr Khoma ◽  
Miho Mugino ◽  
Gregory Falk
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Laparoscopic Fundoplication ◽  
Conflicts Of Interest ◽  
Hiatal Hernia Repair ◽  
Post Operative Period ◽  
Giant Hiatal Hernia

Abstract Background Patients with giant hiatal herniae are often symptomatic and have significantly reduced quality of life (QoL). Laparoscopic fundoplication is an established treatment of giant hiatal hernia. Advanced age has been previously shown to be the most significant predictor of mortality and morbidity in hiatal hernia repair. Reported outcomes of laparoscopic fundoplication in patients over the age of 80 are limited to case reports and small case series. Methods Data was extracted from a prospectively populated single surgeon database of laparoscopic fundoplication procedures between 1995 and 2014. Patients who were operated for giant HH (> 30% of stomach in the chest) that were aged 80 or older at the time of surgery were included. Quality of life (QOL) data was collected pre-operatively, in early post-operative period (within 12 months) and late post-operative period (24 months or later). QOL data included gastro-intestinal quality of life index (GIQLI), Visick score, dysphagia score and overall satisfaction with surgery. Search of Ryerson index (was conducted to establish month and year of death and calculate post-operative life expectancy. Results Inclusion criteria were met by 89 patients. Average age was 84 (80–93). The proportion of herniated stomach was 70.9% on average (range 30–100%; SD 27.25), the hiatal defect was large in all patients. There was 1 perioperative death from myocardial infarction at 30 days after surgery. There were no other major complications (Clavien-Dindo Grade III-IV). Post-operative survival was an average of 74.5 months (SD 47.8; range 1–233). GIQLI was reduced pre-operatively (mean 91.8; SD 19.4). There was improvement in GIQLI scores on early (mean 101.45; SD 21.2) and late (mean 106.7; SD 19.2; P = 0.005) post-operative follow up. Pre-operative Visick scores (mean 2.92; SD 0.98) have improved significantly in early (mean 1.94; SD 0.97; P = 0.000) and late (mean 2.03; SD 0.99; P = 0.001) post-operative periods. During early post-operative follow up 97% of the patients were satisfied with overall outcome of their operation, whilst 3% were dissatisfied. Overall satisfaction scores remained high on late follow up (93.3% satisfied, 6.7% dissatisfied). Conclusion Findings of this study demonstrate that in carefully selected patients with giant HH surgery is safe and results in improved quality of life post operatively. Disclosure All authors have declared no conflicts of interest.

scholarly journals P-BN11 Patient Reported Outcomes of Phasix™ ST Mesh for Laparoscopic Hiatal Hernia Repair

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Yan Yu Tan ◽  
Sri Vishnu Thulasiraman ◽  
Phanibhushana Munipalle ◽  
Yirupaiahgari Viswanath
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Patient Reported Outcomes ◽  
Hiatal Hernia Repair ◽  
Complication Rates ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Patient Reported

Abstract Background Laparoscopic hiatal hernia repair continues to suffer from high recurrence rates, which has prompted the use of mesh reinforcement by some surgeons. Use of mesh however remains controversial due to its association with complications such as erosion, fibrosis and oesophageal stenosis. Biosynthetic Poly-4-Hydroxybutyrate Phasix™ ST mesh is an emerging technology which combines the durability of synthetic mesh with the remodelling characteristics of biologic mesh and includes an anti-adhesion hydrogel barrier. There is a paucity of patient reported outcome data for Phasix™ ST mesh. This study evaluates early patient reported outcomes following laparoscopic hiatal hernia repair with Phasix™ ST mesh. Methods Adult patients undergoing laparoscopic hiatal hernia repair with Phasix™ ST mesh between July 2020 to June 2021 at our institution were identified. Prospective data, including demographic data and complication rates, was collected from electronic and paper medical records. The 12-Item Short Form Survey (SF-12) was administered to assess quality of life pre-operatively and post-operatively with a minimum 30-day follow-up. Results Fourteen patients (12 female, one male) were included with a median age of 66 years (range 52-79). There were no intraoperative complications, mesh-related complications, re-operation, re-admission, or recurrence at a median follow-up of 4 months (IQR 4.0). Median physical health component (PHC) score was 32.7 (IQR 6.2) at baseline and increased to 41.6 (IQR 13.7) post-operatively. Median difference in PHC score was +11.4 (IQR 10.7). Median mental health component (MHC) score was 39.8 (IQR 12.5) at baseline and increased to 57.4 (IQR 8.2) post-operatively. Mean difference in MHC score was +17.7 (IQR 15.9). Conclusions To our knowledge, this is the first report of outcomes on the use of Phasix™ ST mesh for laparoscopic hiatal hernia repair in the United Kingdom. Our study found that it is associated with improvements in both physical and mental quality of life in the short-term post-operative follow-up, although there is some variation in the degree of improvement reported.

The Use of Standardized Measures to Predict and Assess Quality of Life after Laparoscopic Hiatal Hernia Repair

2018 ◽  
Vol 84 (6) ◽  
pp. 789-795
Author(s):  
Mark Shapiro ◽  
Benjamin E. Lee ◽  
John R. Rutledge ◽  
Robert J. Korst
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Female Gender ◽  
Hiatal Hernia Repair ◽  
Outcome Instrument ◽  
Laparoscopic Hiatal Hernia Repair ◽  
Assess Quality ◽  
Hernia Size

The literature regarding laparoscopic hiatal hernia repair is difficult to interpret because of inconsistencies in describing hernia characteristics and outcome measures. This study was performed to evaluate risk factors for an unsatisfactory outcome after repair using objective definitions of hernia size and a clinically relevant outcome instrument. A retrospective review of a prospectively maintained database was conducted over a seven-year period. Data collected included patient demographics and hernia-related variables. Outcomes were defined using a validated quality of life (QOL) instrument. Postoperatively, the mean total QOL score decreased from 22.9 to 5.8 (P < 0.001). In all, 13.8 per cent of patients had unsatisfactory QOL scores postoperatively. Multivariate analysis showed that high gastroesophageal (GE) junction position (P = 0.03) and female gender (P = 0.02) were the only significant factors associated with an unsatisfactory postoperative QOL. Laparoscopic hiatal hernia repair significantly improves QOL. With respect to predicting clinically relevant outcomes, hernias are best characterized by the position of the GE junction. Females with high GE junction position are at the highest risk for an unsatisfactory outcome.

480 Primary vs. Redo Paraesophageal Hiatal Hernia Repair: A Comparative Analysis of Operative and Quality of Life Outcomes

2016 ◽  
Vol 150 (4) ◽  
pp. S1181
Author(s):  
Hamid R. Zahiri ◽  
Kamran Mohiuddin ◽  
Steven D. Leydorf ◽  
Adam S. Weltz ◽  
George T. Fantry ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Hiatal Hernia Repair ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Paraesophageal Hiatal Hernia

Equal patient satisfaction, quality of life and objective recurrence rate after laparoscopic hiatal hernia repair with and without mesh

2017 ◽  
Vol 31 (9) ◽  
pp. 3673-3680 ◽  
Author(s):  
Jan H. Koetje ◽  
Jelmer E. Oor ◽  
David J. Roks ◽  
Henderik L. Van Westreenen ◽  
Eric J. Hazebroek ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Recurrence Rate ◽  
Hiatal Hernia Repair ◽  
Laparoscopic Hiatal Hernia Repair

scholarly journals Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
M. M. J. Van Rooijen ◽  
T. Tollens ◽  
L. N. Jørgensen ◽  
T. S. de Vries Reilingh ◽  
G. Piessen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
Recurrence Rates ◽  
Elective Repair ◽  
Significant Difference ◽  
Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

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