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

73 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