Open Versus Laparoscopic Hiatal Hernia Repair

Overview

Journal JSLS

Specialty General Surgery

Date 2013 Jun 8

PMID 23743369

Citations 16

Authors

Terrence M Fullum

Tolulope A Oyetunji

Gezzer Ortega

Daniel D Tran

Ian M Woods

Olusola Obayomi-Davies

Orighomisan Pessu

Stephanie R Downing

Edward E Cornwell

Affiliations

Soon will be listed here.

Abstract

Background: The literature reports the efficacy of the laparoscopic approach to paraesophageal hiatal hernia repair. However, its adoption as the preferred surgical approach and the risks associated with paraesophageal hiatal hernia repair have not been reviewed in a large database.

Method: The Nationwide Inpatient Sample dataset was queried from 1998 to 2005 for patients who underwent repair of a complicated (the entire stomach moves into the chest cavity) versus uncomplicated (only the upper part of the stomach protrudes into the chest) paraesophageal hiatal hernia via the laparoscopic, open abdominal, or open thoracic approach. A multivariate analysis was performed controlling for demographics and comorbidities while looking for independent risk factors for mortality.

Results: In total, 23,514 patients met the inclusion criteria. By surgical approach, 55% of patients underwent open abdominal, 35% laparoscopic, and 10% open thoracic repairs. Length of stay was significantly reduced for all patients after laparoscopic repair (P < .001). Age ≥60 years and nonwhite ethnicity were associated with significantly higher odds of death. Laparoscopic repair and obesity were associated with lower odds of death in the uncomplicated group.

Conclusion: Laparoscopic repair of paraesophageal hiatal hernia is associated with a lower mortality in the uncomplicated group. However, older age and Hispanic ethnicity increased the odds of death.

Citing Articles

Current Trends in the Management of Hiatal Hernia: A Literature Review of 10 Years of Data.

Singhal V, Md Suleman A, Senofer N, Singhal V Cureus. 2024; 16(10):e71921.

PMID: 39564064 PMC: 11575107. DOI: 10.7759/cureus.71921.

BRAZILIAN HERNIA AND ABDOMINAL WALL SOCIETY STATEMENT ON LARGE HIATAL HERNIAS MANAGEMENT.

Brandalise A, Herbella F, Luna R, Szachnowicz S, Sallum R, Domene C Arq Bras Cir Dig. 2024; 36:e1787.

PMID: 38324849 PMC: 10841492. DOI: 10.1590/0102-672020230069e1787.

Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor.

Perez Lara F, Zubizarreta Jimenez R, Prieto-Puga Arjona T, Gutierrez Delgado P, Hernandez Carmona J, Hernandez Gonzalez J World J Gastrointest Surg. 2024; 15(12):2739-2746.

PMID: 38222019 PMC: 10784824. DOI: 10.4240/wjgs.v15.i12.2739.

Robotic Hiatal Hernia Repair Associated with Higher Morbidity and Readmission Rates Compared to Laparoscopic Repair: 10-Year Analysis from the National Readmissions Database (NRD).

Klock J, Walters R, Nandipati K J Gastrointest Surg. 2022; 27(3):489-497.

PMID: 36508133 DOI: 10.1007/s11605-022-05548-x.

Laparoscopic repair of large diaphragmatic hernia after left ventricular assist device implantation followed by orthotopic heart transplantation.

Chin K, Ward M, Meyer D, Sanchez C, Leeds S Proc (Bayl Univ Med Cent). 2021; 35(1):101-103.

PMID: 34970052 PMC: 8682844. DOI: 10.1080/08998280.2021.1984820.

References

Willekes C, Edoga J, Frezza E . Laparoscopic repair of paraesophageal hernia. Ann Surg. 1997; 225(1):31-8. PMC: 1190602. DOI: 10.1097/00000658-199701000-00004. View

SKINNER D, Belsey R . Surgical management of esophageal reflux and hiatus hernia. Long-term results with 1,030 patients. J Thorac Cardiovasc Surg. 1967; 53(1):33-54. View

Nason K, Luketich J, Qureshi I, Keeley S, Trainor S, Awais O . Laparoscopic repair of giant paraesophageal hernia results in long-term patient satisfaction and a durable repair. J Gastrointest Surg. 2008; 12(12):2066-75. DOI: 10.1007/s11605-008-0712-7. View

ANDUJAR J, Papasavas P, Birdas T, Robke J, Raftopoulos Y, Gagne D . Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation. Surg Endosc. 2004; 18(3):444-7. DOI: 10.1007/s00464-003-8823-4. View

Low D, Unger T . Open repair of paraesophageal hernia: reassessment of subjective and objective outcomes. Ann Thorac Surg. 2005; 80(1):287-94. DOI: 10.1016/j.athoracsur.2005.02.019. View

Cuschieri A, Shimi S, Nathanson L . Laparoscopic reduction, crural repair, and fundoplication of large hiatal hernia. Am J Surg. 1992; 163(4):425-30. DOI: 10.1016/0002-9610(92)90046-t. View

Allen M, Trastek V, Deschamps C, Pairolero P . Intrathoracic stomach. Presentation and results of operation. J Thorac Cardiovasc Surg. 1993; 105(2):253-8; discussion 258-9. View

Treacy P, Jamieson G . An approach to the management of para-oesophageal hiatus hernias. Aust N Z J Surg. 1987; 57(11):813-7. DOI: 10.1111/j.1445-2197.1987.tb01271.x. View

Ferri L, Feldman L, Stanbridge D, Mayrand S, Stein L, Fried G . Should laparoscopic paraesophageal hernia repair be abandoned in favor of the open approach?. Surg Endosc. 2004; 19(1):4-8. DOI: 10.1007/s00464-004-8903-0. View

10.

Chang C, Tseng C, Chang Y . A surgical emergency due to an incarcerated paraesophageal hernia. Am J Emerg Med. 2008; 27(1):134.e1-134.e3. DOI: 10.1016/j.ajem.2008.05.009. View

11.

Sihvo E, Salo J, Rasanen J, Rantanen T . Fatal complications of adult paraesophageal hernia: a population-based study. J Thorac Cardiovasc Surg. 2009; 137(2):419-24. DOI: 10.1016/j.jtcvs.2008.05.042. View

12.

Hill L . Incarcerated paraesophageal hernia. A surgical emergency. Am J Surg. 1973; 126(2):286-91. DOI: 10.1016/s0002-9610(73)80165-5. View

13.

Parameswaran R, Ali A, Velmurugan S, Adjepong S, Sigurdsson A . Laparoscopic repair of large paraesophageal hiatus hernia: quality of life and durability. Surg Endosc. 2006; 20(8):1221-4. DOI: 10.1007/s00464-005-0691-7. View

14.

Dahlberg P, Deschamps C, Miller D, Allen M, Nichols F, Pairolero P . Laparoscopic repair of large paraesophageal hiatal hernia. Ann Thorac Surg. 2001; 72(4):1125-9. DOI: 10.1016/s0003-4975(01)02972-1. View

15.

Hallissey M, Ratliff D, Temple J . Paraoesophageal hiatus hernia: surgery for all ages. Ann R Coll Surg Engl. 1992; 74(1):23-5. PMC: 2497483. View

16.

PEARSON F, Cooper J, Ilves R, Todd T, Jamieson W . Massive hiatal hernia with incarceration: a report of 53 cases. Ann Thorac Surg. 1983; 35(1):45-51. DOI: 10.1016/s0003-4975(10)61430-0. View

17.

Gangopadhyay N, Perrone J, Soper N, Matthews B, Eagon J, Klingensmith M . Outcomes of laparoscopic paraesophageal hernia repair in elderly and high-risk patients. Surgery. 2006; 140(4):491-8. DOI: 10.1016/j.surg.2006.07.001. View

18.

ELLIS Jr F, CROZIER R, Shea J . Paraesophageal hiatus hernia. Arch Surg. 1986; 121(4):416-20. DOI: 10.1001/archsurg.1986.01400040052007. View

19.

Luketich J, Raja S, Fernando H, Campbell W, Christie N, Buenaventura P . Laparoscopic repair of giant paraesophageal hernia: 100 consecutive cases. Ann Surg. 2000; 232(4):608-18. PMC: 1421193. DOI: 10.1097/00000658-200010000-00016. View

20.

Schauer P, Ikramuddin S, McLaughlin R, GRAHAM T, Slivka A, Lee K . Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg. 1999; 176(6):659-65. DOI: 10.1016/s0002-9610(98)00272-4. View