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Feasibility, safety, and short-term efficacy of the laparoscopic Nissen–Hill hybrid repair

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Abstract

Background

A novel antireflux procedure combining laparoscopic Nissen fundoplication and Hill repair components was tested in 50 patients with paraesophageal hernia (PEH) and/or Barrett’s esophagus (BE) because these two groups have been found to have a high rate of recurrence with conventional repairs.

Methods

Patients with symptomatic PEH and/or non-dysplastic BE underwent repair. Quality of life (QOL) metrics, manometry, EGD, and pH testing were administered pre- and postoperatively.

Results

Fifty patients underwent repair. There was no mortality and four major complications. At 13-month follow-up, there was one (2 %) clinical recurrence, and two (4 %) asymptomatic fundus herniations. Mean DeMeester scores improved from 57.2 to 7.7 (p < 0.0001). Control of preoperative symptoms was achieved in 90 % with 6 % resumption of antisecretory medication. All QOL metrics improved significantly.

Conclusions

The hybrid Nissen–Hill repair for patients with PEH and BE appears safe and clinically effective at short-term follow-up. It is hoped that the combined structural components may reduce the rate of recurrence compared to existing repairs.

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Acknowledgments

We would like to acknowledge the contribution of Justine Rees, the Hill Foundation and the Foundation for Surgical Fellowships.

Disclosure

Aye, Qureshi, Wilshire, Farivar, Vallières, and Louie have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA

    Ralph W. Aye, Alia P. Qureshi, Candice L. Wilshire, Alexander S. Farivar, Eric Vallières & Brian E. Louie

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  1. Ralph W. Aye
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  2. Alia P. Qureshi
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  3. Candice L. Wilshire
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  4. Alexander S. Farivar
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  5. Eric Vallières
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  6. Brian E. Louie
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Correspondence to Ralph W. Aye.

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Aye, R.W., Qureshi, A.P., Wilshire, C.L. et al. Feasibility, safety, and short-term efficacy of the laparoscopic Nissen–Hill hybrid repair. Surg Endosc 30, 551–558 (2016). https://doi.org/10.1007/s00464-015-4238-2

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  • DOI: https://doi.org/10.1007/s00464-015-4238-2

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