Laparoscopic Hiatal Hernia Repair with Falciform Ligament Buttress.
J Gastrointest Surg
; 22(7): 1144-1151, 2018 07.
Article
en En
| MEDLINE
| ID: mdl-29736666
ABSTRACT
BACKGROUND:
Using synthetic mesh to buttress the crural repair during laparoscopic hiatal hernia repair may be associated with dysphagia and esophageal erosions, while a biologic mesh is expensive and does not decrease long-term recurrence rates. This study documents outcomes of laparoscopic paraesophageal hernia repairs using the falciform ligament to reinforce the crural repair.METHODS:
This is a prospective study of laparoscopic paraesophageal hernia repairs with a falciform ligament buttress. Preoperatively and at 6 and 12 months postoperatively, medications, radiologic studies, and symptom severity and frequency scores were recorded. Patients with a hiatal defect greater than 5 cm were included, while patients with recurrent hiatal hernia repairs or prior gastric surgery were excluded. Symptom scores were compared pre- and postoperatively with a p < 0.05 considered significant.RESULTS:
One hundred four patients were included with a mean age of 62.4 years, and 57 patients underwent an upper gastrointestinal series at least 12 months from the initial operation with a mean follow-up of 20.6 months. The mean symptom severity score decreased from 14.32 ± 0.93 to 4.75 ± 0.97 (p < 0.001), mean symptom frequency score decreased from 14.99 ± 0.97 to 5.25 ± 0.99 (p < 0.001), and mean total symptom score decreased from 29.31 ± 1.88 to 10.00 ± 1.95 (p < 0.001). Five patients developed recurrent hiatal hernias on upper gastrointestinal series, but only three required operative intervention.CONCLUSIONS:
Laparoscopic paraesophageal hernia repair with a falciform ligament buttress is a viable option for a durable closure. Ongoing follow-up will continue to illuminate the value of this approach to decrease morbidity and recurrence rates for hiatal hernia repair.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Laparoscopía
/
Herniorrafia
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Hernia Hiatal
/
Ligamentos
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Gastrointest Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos