Laparoscopic management of giant hiatal hernia : factors influencing long-term outcome
The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate. In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal def...
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| Veröffentlicht in: | Surgical endoscopy 2006-07, Vol.20 (7), p.1011-1016 |
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| creator | MORINO, M GIACCONE, C PELLEGRINO, L REBECCHI, F |
| description | The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate.
In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. "Tension-free" repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis-Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction.
There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis-Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique.
To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis-Nissen procedure in such cases. |
| doi_str_mv | 10.1007/s00464-005-0550-6 |
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In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. "Tension-free" repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis-Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction.
There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis-Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique.
To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis-Nissen procedure in such cases.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-005-0550-6</identifier><identifier>PMID: 16763927</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York, NY: Springer</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anemia ; Biological and medical sciences ; Digestive system. Abdomen ; Dyspnea ; Endoscopy ; Esophagus ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastroesophageal reflux ; Hernia, Hiatal - pathology ; Hernia, Hiatal - surgery ; Hiatal hernias ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy ; Male ; Medical sciences ; Middle Aged ; Mortality ; Other diseases. Semiology ; Retrospective Studies ; Stomach ; Surgery ; Surgical techniques ; Time Factors ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2006-07, Vol.20 (7), p.1011-1016</ispartof><rights>2006 INIST-CNRS</rights><rights>Springer Science+Business Media, Inc. 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-17155275fe356269ef3a770240df8ca587fb2ed6adaeed91baaa1a547f87d263</citedby><cites>FETCH-LOGICAL-c422t-17155275fe356269ef3a770240df8ca587fb2ed6adaeed91baaa1a547f87d263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18010472$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16763927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MORINO, M</creatorcontrib><creatorcontrib>GIACCONE, C</creatorcontrib><creatorcontrib>PELLEGRINO, L</creatorcontrib><creatorcontrib>REBECCHI, F</creatorcontrib><title>Laparoscopic management of giant hiatal hernia : factors influencing long-term outcome</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description>The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate.
In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. "Tension-free" repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis-Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction.
There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis-Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique.
To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis-Nissen procedure in such cases.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Dyspnea</subject><subject>Endoscopy</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastroesophageal reflux</subject><subject>Hernia, Hiatal - pathology</subject><subject>Hernia, Hiatal - surgery</subject><subject>Hiatal hernias</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Other diseases. Semiology</subject><subject>Retrospective Studies</subject><subject>Stomach</subject><subject>Surgery</subject><subject>Surgical techniques</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpd0M9rHCEUwHEpDckmzR_QS5FAcjNVZ9QxtxDyCxZ6Cb3KW-e5mTCjW5059L-vyy4EetLD5z0eX0K-C34rODc_C-etbhnninGlONNfyEq0jWRSiu4rWXHbcCaNbc_IeSkfvHIr1Ck5E9roxkqzIr_XsIOcik-7wdMJImxxwjjTFOh2gPp5H2CGkb5jjgPQOxrAzykXOsQwLhj9ELd0THHLZswTTcvs04TfyEmAseDl8b0gb0-Pbw8vbP3r-fXhfs18K-XMhBFKSaMCNkpLbTE0YAyXLe9D50F1Jmwk9hp6QOyt2ACAANWa0Jle6uaC3BzW7nL6s2CZ3TQUj-MIEdNSnO60tJ2xFV79Bz_SkmM9zUlhlZCyExWJA_I1SMkY3C4PE-S_TnC3D-4OwV0N7vbB3f6CH8fFy2bC_nPiWLiC6yOA4mEMGWqy8uk6LnhrZPMPBA6IjA</recordid><startdate>20060701</startdate><enddate>20060701</enddate><creator>MORINO, M</creator><creator>GIACCONE, C</creator><creator>PELLEGRINO, L</creator><creator>REBECCHI, F</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20060701</creationdate><title>Laparoscopic management of giant hiatal hernia : factors influencing long-term outcome</title><author>MORINO, M ; GIACCONE, C ; PELLEGRINO, L ; REBECCHI, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-17155275fe356269ef3a770240df8ca587fb2ed6adaeed91baaa1a547f87d263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Biological and medical sciences</topic><topic>Digestive system. Abdomen</topic><topic>Dyspnea</topic><topic>Endoscopy</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastroesophageal reflux</topic><topic>Hernia, Hiatal - pathology</topic><topic>Hernia, Hiatal - surgery</topic><topic>Hiatal hernias</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Other diseases. Semiology</topic><topic>Retrospective Studies</topic><topic>Stomach</topic><topic>Surgery</topic><topic>Surgical techniques</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MORINO, M</creatorcontrib><creatorcontrib>GIACCONE, C</creatorcontrib><creatorcontrib>PELLEGRINO, L</creatorcontrib><creatorcontrib>REBECCHI, F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MORINO, M</au><au>GIACCONE, C</au><au>PELLEGRINO, L</au><au>REBECCHI, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic management of giant hiatal hernia : factors influencing long-term outcome</atitle><jtitle>Surgical endoscopy</jtitle><addtitle>Surg Endosc</addtitle><date>2006-07-01</date><risdate>2006</risdate><volume>20</volume><issue>7</issue><spage>1011</spage><epage>1016</epage><pages>1011-1016</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate.
In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. "Tension-free" repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis-Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction.
There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis-Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique.
To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis-Nissen procedure in such cases.</abstract><cop>New York, NY</cop><pub>Springer</pub><pmid>16763927</pmid><doi>10.1007/s00464-005-0550-6</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anemia Biological and medical sciences Digestive system. Abdomen Dyspnea Endoscopy Esophagus Female Gastroenterology. Liver. Pancreas. Abdomen Gastroesophageal reflux Hernia, Hiatal - pathology Hernia, Hiatal - surgery Hiatal hernias Humans Investigative techniques, diagnostic techniques (general aspects) Laparoscopy Male Medical sciences Middle Aged Mortality Other diseases. Semiology Retrospective Studies Stomach Surgery Surgical techniques Time Factors Treatment Outcome |
| title | Laparoscopic management of giant hiatal hernia : factors influencing long-term outcome |
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