Journal of Gastrointestinal Surgery

, Volume 16, Issue 3, pp 453–459 | Cite as

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
2011 SSAT Plenary Presentation

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.

Keywords

Laparoscopic paraesophageal hernia Recurrence rate Long-term clinical outcomes 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Brant K. Oelschlager
    • 1
  • Rebecca P. Petersen
    • 1
  • L. Michael Brunt
    • 1
  • Nathaniel J. Soper
    • 2
  • Brett C. Sheppard
    • 3
  • Lee Mitsumori
    • 4
  • Charles Rohrmann
    • 4
  • Lee L. Swanstrom
    • 5
  • Carlos A. Pellegrini
    • 1
  1. 1.Department of SurgeryUniversity of WashingtonSeattleUSA
  2. 2.Department of SurgeryNorthwestern UniversityEvanstonUSA
  3. 3.Department of SurgeryOregon Health & Science UniversityPortlandUSA
  4. 4.Department of RadiologyUniversity of WashingtonSeattleUSA
  5. 5.Department of SurgeryThe Oregon ClinicPortlandUSA

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