scholarly journals Hiatus Hernia Repair with Bilateral Oesophageal Fixation

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Rajith Mendis ◽  
Caran Cheung ◽  
David Martin
Keyword(s):  
Patient Satisfaction ◽  
Hernia Repair ◽  
Hiatus Hernia ◽  
Symptom Control ◽  
Hernia Recurrence ◽  
Barium Swallow ◽  
Oesophageal Perforation ◽  
Symptom Improvement ◽  
Prospective Database

Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence.Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL), PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy.Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38,P<0.01), Visick (3 to 1), and RSI (17.45 to 5,P<0.01). PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%). 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation.Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability.

470 OUTCOMES OF COMPOSITE REPAIR OF GIANT HIATAL HERNIA IN A LARGE SINGLE CENTRE COHORT.

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
F Lee ◽  
O Khoma ◽  
M Mendu ◽  
G Falk
Keyword(s):  
Quality Of Life ◽  
Hiatus Hernia ◽  
Revision Surgery ◽  
Hernia Recurrence ◽  
Barium Swallow ◽  
Single Centre ◽  
Composite Repair ◽  
Perioperative Morbidity ◽  
Giant Hiatal Hernia

Abstract   Giant hiatus hernia (GHH) is usually symptomatic and can have significant impact on a patient’s quality of life. There is ongoing debate about optimal technique of giant hiatus hernia repair. This paper aims to look at the outcomes of laparoscopic composite repair of giant hiatus hernia from a large single centre cohort. Methods A retrospective analysis of prospectively maintained database was performed. Patients undergoing composite repair for GHH defined as &gt;30% stomach above diaphragm were included. Primary outcome was hernia recurrence. Secondary outcomes were perioperative morbidity and mortality, correlation of symptoms and hernia recurrence post operatively, need for revision surgery, resolution of symptoms post operatively and patient self-reported quality of life (GIQOL, Visik score). Results Inclusion criteria were met by 221 patients. Post-operative endoscopic and/or barium swallow follow up was performed in 198 patients with 23.74% recurrence rate. There was no correlation with recurrence of hernia and persistent post-operative symptoms. The most common presenting symptom was shortness of breath, followed by dysphagia, chest pain and heartburn. Dysphagia was most common post-operative symptom. There was significant improvement in QOL post-operatively. Conclusion Laparoscopic composite repair was proven safe and effective in this cohort. Hernia recurrence was not associated with ongoing symptoms and did not have an effect on QOL. A small proportion of patients with recurrence required revision surgery. Overall satisfaction with surgery was high.

scholarly journals P-BN52 Patient-reported outcome measures following fundoplication – lind and nissens - single centre, single surgeon results

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Anitha Muthusami ◽  
Sindoora Jayaprakash ◽  
Akash Jangan ◽  
Chaminda Sellahewa ◽  
Akinfemi Akingboye
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Hiatus Hernia ◽  
Reflux Disease ◽  
Oesophageal Reflux ◽  
Symptom Improvement ◽  
Oesophageal Reflux Disease ◽  
The Impact

Abstract Background Gastro-oesophageal reflux disease (GORD) affects approximately 10%-20% of adults in Western Countries. Surgery is indicated following failed medical therapy. This is recommended when GORD symptoms have a significant impact on the quality of life (QOL). A long term follow up is critical to authenticate outcomes following anti-reflux/hiatal hernia repair surgery. Objective information must be linked to the patient’s perception of the disease and the impact on the QOL. Our survey aims assess the long term patient’s satisfaction and the impact on QOL following standard Nissen’s and Lind’s fundoplication for GORD. Methods A single surgeon’s prospective database of laparoscopic and or open hiatus hernia repair and fundoplication with patient’s demographics since 2014 in a district general hospital was analyzed. These patients were contacted virtually between June and July 2021. Verbal consent was obtained,  the patients were asked to answer questions from the GERD HRQL (AUGIS modified for use in National Hiatal Surgery Registry) for Hiatus Hernia (HH) or Gastro-oesophageal reflux disease (GORD) or both to assess postoperative symptoms relief, complications, and overall quality of life. The scoring scale was divided into two categories; no symptoms or mild–moderate symptom improvement and those with significant symptoms. Results Of the 93 patients, 85 (91.4%) underwent primary laparoscopic repair with 91 cases performed as elective procedure. 68 patients (73%) underwent a Lind wrap, 24 (26%) had a floppy Nissen’s and one was a dor procedure. Three patients with unrelated death were excluded from the analysis. We had 67 responders (74.4%), 56 answered the GORD questionnaire and 66 responded to the HH questionnaire.  84% patients with GORD and 85% of patients with HH had significant symptom improvement. 61 % and 55% suffered from significant gas bloat symptoms in each group. As for dysphagia; 77% had no - mild dysphagia and 23% had significant dysphagia and this was 79% and 21% in HH group.  Conclusions Overall patients satisfaction and improvement in quality of life was 90% . Half of our patient experienced gas bloat syndrome, which had little effect on their quality of life. 20% had long term dysphagia and one third of the patients seem to continue to use PPI despite expressing a satisfactory clinical improvement. It appears that patient’s long term improvement on  the   quality of life was satisfactory from both Nissen’s and Lind procedure.

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.

Spontaneous oesophageal perforation after laparoscopic hiatus hernia repair

2014 ◽  
Vol 85 (11) ◽  
pp. 887-888
Author(s):  
Martyn L. Humphreys ◽  
Bevan Jenkins ◽  
Jason Robertson ◽  
Michael Rodgers
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Oesophageal Perforation

Permanent mesh results in long-term symptom improvement and patient satisfaction without increasing adverse outcomes in hiatal hernia repair

2014 ◽  
Vol 207 (3) ◽  
pp. 445-448 ◽  
Author(s):  
Lindsay F. Petersen ◽  
Shannon L. McChesney ◽  
Shaun C. Daly ◽  
Keith W. Millikan ◽  
Jonathan A. Myers ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Adverse Outcomes ◽  
Symptom Improvement ◽  
Hiatal Hernia Repair

scholarly journals Quality of life after giant hiatus hernia repair: A systematic review

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
AkshayR Date ◽  
YanMei Goh ◽  
YanLi Goh ◽  
Ilayaraja Rajendran ◽  
RavindraS Date
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Hernia Repair ◽  
Hiatus Hernia

O168 VERY LONG-TERM (5-19 YEARS) FOLLOW-UP OF PARAESOPHAGEAL HERNIA REPAIR: PERMANENT MESH vs STANDARD CRUROPLASTY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Pamela Milito ◽  
Simone Zanghì ◽  
Andrea Sironi ◽  
Emanuele Asti ◽  
Luigi Bonavina
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Paraesophageal Hernia ◽  
Synthetic Mesh ◽  
Hernia Recurrence ◽  
Paraesophageal Hernia Repair ◽  
Long Term Follow Up ◽  
Large Hiatus Hernia

Abstract Aim Aim of this comparative study was to analyze very long-term safety, symptomatic outcomes and rate of recurrence in a cohort of patients who underwent large hiatus hernia repair with or without synthetic mesh. Background & Methods The use of a permanent mesh to reinforce the hiatus could reduce the rate of radiological and symptomatic recurrences after laparoscopic paraesophageal hernia repair. However, strictures and even erosions into the esophageal lumen have been reported. Aim of this comparative study was to analyze very long-term safety, symptomatic outcomes and rate of recurrence in a cohort of patients who underwent large hiatus hernia repair with or without synthetic mesh. Observational cohort study using a prospectively maintained database. From November 2001 to September 2005, 39 consecutive patients underwent laparoscopic repair and fundoplication for large hiatus hernia (> 5 cm). Thirteen patients (Group M) received crural reinforcement with non-absorbable mesh, while 26 patients (Group S) underwent standard cruroplasty. Mesh-related complications, postoperative symptoms and hernia recurrence at very long-term follow-up through upper gastrointestinal endoscopy, GERD-HRQL and FOREGUT questionnaires. Results There were 23 women and 16 men, with a median age of 60 years (range 28-81). The hernia size was similar in both groups. Postoperative complications occurred in 2 patients (5.1%) and there was no mortality. The median long-term follow-up was 168 months (range 139-197 months, IQR: 23.5). At last follow-up visit, occasional (once a month) dysphagia occurred in 23% of Group M patients, but none required endoscopic dilatation. The hernia recurrence rate was 0. No short or long-term complications related to the use of the mesh were recorded. In group S, non of patients, complained of dysphagia, whereas 2 (7.7%) patients complained of occasional reflux symptoms and other 2 (7.7%) of dyspepsia. In 4 patients (15.4%), a small hiatus hernia recurrence or a partially slipped fundoplication was noted, but all patients were asymptomatic. GERD-HRQL scores significantly decrease in both groups (p<0.05). Conclusion Laparoscopic antireflux surgery with permanent prosthetic mesh is an effective and safe procedure in carefully selected patients with large hiatal hernia.

P169 COMPARISON OF LAPAROSCOPIC TOUPET FUNDOPLICATION AND MAGNETIC SPHINCTER AUGMENTATION IN PATIENTS WITH 3-5 CM HIATUS HERNIA

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
V Lazzari ◽  
P Milito ◽  
R Scaramuzzo ◽  
E Asti ◽  
L Bonavina
Keyword(s):  
Quality Of Life ◽  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Barium Swallow ◽  
Magnetic Sphincter Augmentation ◽  
Toupet Fundoplication ◽  
Laparoscopic Toupet Fundoplication ◽  
Significant Difference ◽  
Large Hiatus Hernia

Abstract Aim To compare quality of life in patients with large hiatus hernia undergoing laparoscopic Toupet fundoplication and magnetic sphincter augmentation. Background and Methods Laparoscopic Toupet fundoplication (LTF) and laparoscopic magnetic sphincter augmentation (MSA) have been compared in a previous retrospective study (Asti E et al, Medicine, 2016) in patients with small hiatal hernia (<3 cm). There is no universal consensus in the use of MSA in patients with large hiatus hernia. This is an observational, retrospective, comparative cohort study. Patients with <3 cm or >5 cm hiatus hernia measured by endoscopy and barium swallow study and those with previous esophago-gastric surgery were excluded. The primary outcome was quality of life based on the Gastro-Esophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire. Secondary outcomes were proton pump inhibitors (PPI) use, incidence of dysphagia and gas-related symptoms, and hiatus hernia recurrence rate. Results Between March 2007 and June 2018, 150 patients with GERD met the inclusion criteria; 88 underwent a LTF and 62 a MSA procedure. Both groups had similar preoperative features. The mean follow-up was 64 months and all patients were followed for at least one year after surgery. There was no statistically significant difference between LTF and MSA in GERD-HRQL scores (p=0.178), PPI use (p=0.327), gas-related symptoms (p=0.162), dysphagia (p=0.254), and reoperation rate (p=0.167). Conclusion Both LTF and MSA have similar safety profile and disease-specific quality of life in patients with large hiatal hernia.

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