Should Laparoscopic Paraesophageal Hernia Repair Be Abandoned in Favor of the Open Approach?

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2004 Nov 9

PMID 15531968

Citations 29

Authors

L E Ferri

L S Feldman

D Stanbridge

S Mayrand

L Stein

G M Fried

Affiliations

Soon will be listed here.

Abstract

Background: The most appropriate approach to the repair of large paraesophageal hernias remains controversial. Despite early results of excellent outcomes after laparoscopic repair, recent reports of high recurrence require that this approach be reevaluated.

Methods: For this study, 60 primary paraesophageal hernias consecutively repaired at one institution from 1990 to 2002 were reviewed. These 25 open transabdominal and 35 laparoscopic repairs were compared for operative, short-, and long-term outcomes on the basis of quality-of -life questionnaires and radiographs.

Results: No difference in patient characteristics was detected. Laparoscopic repair resulted in lower blood loss, fewer intraoperative complications, and a shorter length of hospital stay. No difference in general or disease-specific quality-of-life was documented. Radiographic follow-up was available for 78% open and 91% laparoscopic repairs, showing anatomic recurrence rates of 44% and 23%, respectively (p = 0.11).

Conclusions: Laparoscopic repair should remain in the forefront for the management of paraesophageal hernias. However, there is considerable room for improvement in reducing the incidence of recurrence.

Citing Articles

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

Date A, Goh Y, Goh Y, Rajendran I, Date R J Minim Access Surg. 2021; 17(4):435-449.

PMID: 33885030 PMC: 8486064. DOI: 10.4103/jmas.JMAS_233_20.

Surgical Techniques for Robotically-Assisted Laparoscopic Paraesophageal Hernia Repair.

Ekeke C, Vercauteren M, Baker N, Sarkaria I Thorac Surg Clin. 2019; 29(4):369-377.

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Treatment of giant paraesophageal hernia: pro laparoscopic approach.

Dallemagne B, Quero G, Lapergola A, Guerriero L, Fiorillo C, Perretta S Hernia. 2017; 22(6):909-919.

PMID: 29177588 DOI: 10.1007/s10029-017-1706-8.

Minimally Invasive Surgery Should Be the Standard of Care for Paraesophageal Hernia Repair.

Schlottmann F, Strassle P, Farrell T, Patti M J Gastrointest Surg. 2017; 21(5):778-784.

PMID: 28063123 DOI: 10.1007/s11605-016-3345-2.

Laparoscopic Hiatal Hernia Repair in the Elderly Patient.

Oor J, Koetje J, Roks D, Nieuwenhuijs V, Hazebroek E World J Surg. 2016; 40(6):1404-11.

PMID: 26810989 DOI: 10.1007/s00268-016-3428-y.

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