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Management of Minimally Symptomatic Recurrent Hiatal Hernia

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Difficult Decisions in Thoracic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY,volume 1))

Abstract

Recurrent hiatal hernias are a common and challenging clinical problem. The goal of this chapter is to provide guidance on the management of patients with minimally symptomatic recurrent hiatal hernias. To this end, we review the epidemiology and mechanisms of these recurrences and discuss the clinical features that are necessary to consider when deciding the appropriate management for patients with recurrent hiatal hernias.

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References

  1. Dallemagne B, Kohnen L, Perretta S, Weerts J, Markiewicz S, Jehaes C. Laparoscopic repair of paraesophageal hernia. Long-term follow-up reveals good clinical outcome despite high radiological recurrence rate. Ann Surg. 2011;253(2):291–6.

    Article  PubMed  Google Scholar 

  2. Wiechmann RJ, Ferguson MK, Naunheim KS, McKesey P, Hazelrigg SJ, Santucci TS, et al. Laparoscopic management of giant paraesophageal herniation. Ann Thorac Surg. 2001;71(4):1080–6; discussion 1086–7.

    Article  CAS  PubMed  Google Scholar 

  3. Aly A, Munt J, Jamieson GG, Ludemann R, Devitt PG, Watson DI. Laparoscopic repair of large hiatal hernias. Br J Surg. 2005;92(5):648–53.

    Article  CAS  PubMed  Google Scholar 

  4. Fullum TM, Oyetunji TA, Ortega G, Tran DD, Woods IM, Obayomi-Davies O, et al. Open versus laparoscopic hiatal hernia repair. JSLS. 2013;17(1):23–9.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Nguyen NT, Christie C, Masoomi H, Matin T, Laugenour K, Hohmann S. Utilization and outcomes of laparoscopic versus open paraesophageal hernia repair. Am Surg. 2011;77(10):1353–7.

    PubMed  Google Scholar 

  6. Fisichella PM, Patti MG. Laparoscopic repair of paraesophageal hiatal hernias. J Laparoendosc Adv Surg Tech A. 2008;18(4):629–32.

    Article  PubMed  Google Scholar 

  7. Mattar SG, Bowers SP, Galloway KD, Hunter JG, Smith CD. Long-term outcome of laparoscopic repair of paraesophageal hernia. Surg Endosc. 2002;16(5):745–9.

    Article  CAS  PubMed  Google Scholar 

  8. Edye MB, Canin-Endres J, Gattorno F, Salky BA. Durability of laparoscopic repair of paraesophageal hernia. Ann Surg. 1998;228(4):528–35.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Smith CD, McClusky DA, Rajad MA, Lederman AB, Hunter JG. When fundoplication fails: redo? Ann Surg. 2005;241(6):861–9; discussion 869–71.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Hashemi M, Peters JH, DeMeester TR, Huprich JE, Quek M, Hagen JA, et al. Laparoscopic repair of large type III hiatal hernia: objective followup reveals high recurrence rate. J Am Coll Surg. 2000;190(5):553–60; discussion 560–1.

    Article  CAS  PubMed  Google Scholar 

  11. Zehetner J, Demeester SR, Ayazi S, Kilday P, Augustin F, Hagen JA, et al. Laparoscopic versus open repair of paraesophageal hernia: the second decade. J Am Coll Surg. 2011;212(5):813–20.

    Article  PubMed  Google Scholar 

  12. Finlayson SR, Laycock WS, Birkmeyer JD. National trends in utilization and outcomes of antireflux surgery. Surg Endosc. 2003;17(6):864–7.

    Article  CAS  PubMed  Google Scholar 

  13. Musunuru S, Gould JC. Perioperative outcomes of surgical procedures for symptomatic fundoplication failure: a retrospective case-control study. Surg Endosc. 2012;26(3):838–42.

    Article  PubMed  Google Scholar 

  14. Coelho JC, Goncalves CG, Claus CM, Andrigueto PC, Ribeiro MN. Late laparoscopic reoperation of failed antireflux procedures. Surg Laparosc Endosc Percutan Tech. 2004;14(3):113–7.

    Article  PubMed  Google Scholar 

  15. Seelig MH, Hinder RA, Klingler PJ, Floch NR, Branton SA, Smith SL. Paraesophageal herniation as a complication following laparoscopic antireflux surgery. J Gastrointest Surg. 1999;3(1):95–9.

    Article  CAS  PubMed  Google Scholar 

  16. Zaninotto G, Portale G, Costantini M, Fiamingo P, Rampado S, Guirroli E, et al. Objective follow-up after laparoscopic repair of large type III hiatal hernia. Assessment of safety and durability. World J Surg. 2007;31(11):2177–83.

    Article  PubMed  Google Scholar 

  17. Luketich JD, Nason KS, Christie NA, Pennathur A, Jobe BA, Landreneau RJ, et al. Outcomes after a decade of laparoscopic giant paraesophageal hernia repair. J Thorac Cardiovasc Surg. 2010;139(2):395–404. e1.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Dahlberg PS, Deschamps C, Miller DL, Allen MS, Nichols FC, Pairolero PC. Laparoscopic repair of large paraesophageal hiatal hernia. Ann Thorac Surg. 2001;72(4):1125–9.

    Article  CAS  PubMed  Google Scholar 

  19. Wu JS, Dunnegan DL, Soper NJ. Clinical and radiologic assessment of laparoscopic paraesophageal hernia repair. Surg Endosc. 1999;13(5):497–502.

    Article  CAS  PubMed  Google Scholar 

  20. Lidor AO, Kawaji Q, Stem M, Fleming RM, Schweitzer MA, Steele KE, et al. Defining recurrence after paraesophageal hernia repair: correlating symptoms and radiographic findings. Surgery. 2013;154(2):171–8.

    Article  PubMed  Google Scholar 

  21. Gibson SC, Wong SC, Dixon AC, Falk GL. Laparoscopic repair of giant hiatus hernia: prosthesis is not required for successful outcome. Surg Endosc. 2013;27(2):618–23.

    Article  PubMed  Google Scholar 

  22. Oelschlager BK, Petersen RP, Brunt LM, Soper NJ, Sheppard BC, Mitsumori L, et al. Laparoscopic paraesophageal hernia repair: defining long-term clinical and anatomic outcomes. J Gastrointest Surg. 2012;16(3):453–9.

    Article  PubMed  Google Scholar 

  23. White BC, Jeansonne LO, Morgenthal CB, Zagorski S, Davis SS, Smith CD, et al. Do recurrences after paraesophageal hernia repair matter?: Ten-year follow-up after laparoscopic repair. Surg Endosc. 2008;22(4):1107–11.

    Article  CAS  PubMed  Google Scholar 

  24. Targarona EM, Novell J, Vela S, Cerdan G, Bendahan G, Torrubia S, et al. Mid term analysis of safety and quality of life after the laparoscopic repair of paraesophageal hiatal hernia. Surg Endosc. 2004;18(7):1045–50.

    Article  CAS  PubMed  Google Scholar 

  25. Andujar JJ, Papasavas PK, Birdas T, Robke J, Raftopoulos Y, Gagne DJ, et al. Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation. Surg Endosc. 2004;18(3):444–7.

    Article  CAS  PubMed  Google Scholar 

  26. Diaz S, Brunt LM, Klingensmith ME, Frisella PM, Soper NJ. Laparoscopic paraesophageal hernia repair, a challenging operation: medium-term outcome of 116 patients. J Gastrointest Surg. 2003;7(1):59–66. discussion -7.

    Article  PubMed  Google Scholar 

  27. Trus TL, Bax T, Richardson WS, Branum GD, Mauren SJ, Swanstrom LL, et al. Complications of laparoscopic paraesophageal hernia repair. J Gastrointest Surg. 1997;1(3):221–7. discussion 8.

    Article  CAS  PubMed  Google Scholar 

  28. Jobe BA, Aye RW, Deveney CW, Domreis JS, Hill LD. Laparoscopic management of giant type III hiatal hernia and short esophagus. Objective follow-up at three years. J Gastrointest Surg. 2002;6(2):181–8. discussion 8.

    Article  PubMed  Google Scholar 

  29. Horgan S, Eubanks TR, Jacobsen G, Omelanczuk P, Pellegrini CA. Repair of paraesophageal hernias. Am J Surg. 1999;177(5):354–8.

    Article  CAS  PubMed  Google Scholar 

  30. Furnee EJ, Draaisma WA, Gooszen HG, Hazebroek EJ, Smout AJ, Broeders IA. Tailored or routine addition of an antireflux fundoplication in laparoscopic large hiatal hernia repair: a comparative cohort study. World J Surg. 2011;35(1):78–84.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Hill LD. Incarcerated paraesophageal hernia. A surgical emergency. Am J Surg. 1973;126(2):286–91.

    Article  CAS  PubMed  Google Scholar 

  32. Willwerth BM. Gastric complications associated with paraesophageal herniation. Am Surg. 1974;40(6):366–9.

    CAS  PubMed  Google Scholar 

  33. Juhasz A, Sundaram A, Hoshino M, Lee TH, Mittal SK. Outcomes of surgical management of symptomatic large recurrent hiatus hernia. Surg Endosc. 2012;26(6):1501–8.

    Article  PubMed  Google Scholar 

  34. Greene CL, Demeester SR, Zehetner J, Worrell SG, Oh DS, Hagen JA. Diaphragmatic relaxing incisions during laparoscopic paraesophageal hernia repair. Surg Endosc. 2013;27:4532–8.

    Article  PubMed  Google Scholar 

  35. Lubezky N, Sagie B, Keidar A, Szold A. Prosthetic mesh repair of large and recurrent diaphragmatic hernias. Surg Endosc. 2007;21(5):737–41.

    Article  PubMed  Google Scholar 

  36. Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999;94(10):2840–4.

    Article  CAS  PubMed  Google Scholar 

  37. Perez AR, Moncure AC, Rattner DW. Obesity adversely affects the outcome of antireflux operations. Surg Endosc. 2001;15(9):986–9.

    Article  CAS  PubMed  Google Scholar 

  38. Kasotakis G, Mittal SK, Sudan R. Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese. JSLS. 2011;15(2):188–92.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Amini A, Vaziri K, Nagle AP. Simultaneous laparoscopic type III paraesophageal hernia repair with porcine small intestine submucosa and Roux-en-y gastric bypass. Surg Obes Relat Dis. 2008;4(6):764–7.

    Article  PubMed  Google Scholar 

  40. Salvador-Sanchis JL, Martinez-Ramos D, Herfarth A, Rivadulla-Serrano I, Ibanez-Belenguer M, Hoashi JS. Treatment of morbid obesity and hiatal paraesophageal hernia by laparoscopic Roux-en-y gastric bypass. Obes Surg. 2010;20(6):801–3.

    Article  PubMed  Google Scholar 

  41. Varela JE. Laparoscopic biomesh hiatoplasty and sleeve gastrectomy in a morbidly obese patient with hiatal hernia. Surg Obes Relat Dis. 2009;5(6):707–9.

    Article  PubMed  Google Scholar 

  42. Korwar V, Peters M, Adjepong S, Sigurdsson A. Laparoscopic hiatus hernia repair and simultaneous sleeve gastrectomy: a novel approach in the treatment of gastroesophageal reflux disease associated with morbid obesity. J Laparoendosc Adv Surg Tech A. 2009;19(6):761–3.

    Article  PubMed  Google Scholar 

  43. Merchant AM, Cook MW, Srinivasan J, Davis SS, Sweeney JF, Lin E. Comparison between laparoscopic paraesophageal hernia repair with sleeve gastrectomy and paraesophageal hernia repair alone in morbidly obese patients. Am Surg. 2009;75(7):620–5.

    PubMed  Google Scholar 

  44. Cuenca-Abente F, Parra JD, Oelschlager BK. Laparoscopic sleeve gastrectomy: an alternative for recurrent paraesophageal hernias in obese patients. JSLS. 2006;10(1):86–9.

    PubMed Central  PubMed  Google Scholar 

  45. Rodriguez JH, Kroh M, El-Hayek K, Timratana P, Chand B. Combined paraesophageal hernia repair and partial longitudinal gastrectomy in obese patients with symptomatic paraesophageal hernias. Surg Endosc. 2012;26(12):3382–90.

    Article  PubMed  Google Scholar 

  46. Low DE, Unger T. Open repair of paraesophageal hernia: reassessment of subjective and objective outcomes. Ann Thorac Surg. 2005;80(1):287–94.

    Article  PubMed  Google Scholar 

  47. Khaitan L, Houston H, Sharp K, Holzman M, Richards W. Laparoscopic paraesophageal hernia repair has an acceptable recurrence rate. Am Surg. 2002;68(6):546–51; discussion 551–2.

    PubMed  Google Scholar 

  48. Gangopadhyay N, Perrone JM, Soper NJ, Matthews BD, Eagon JC, Klingensmith ME, et al. Outcomes of laparoscopic paraesophageal hernia repair in elderly and high-risk patients. Surgery. 2006;140(4):491–8; discussion 498–9.

    Article  PubMed  Google Scholar 

  49. Pierre AF, Luketich JD, Fernando HC, Christie NA, Buenaventura PO, Litle VR, et al. Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg. 2002;74(6):1909–15; discussion 1915–6.

    Article  PubMed  Google Scholar 

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Correspondence to Brant K. Oelschlager MD .

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Oelschlager, B.K., Yates, R.B. (2014). Management of Minimally Symptomatic Recurrent Hiatal Hernia. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach, vol 1. Springer, London. https://doi.org/10.1007/978-1-4471-6404-3_41

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  • DOI: https://doi.org/10.1007/978-1-4471-6404-3_41

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