Functional results after hiatal repair and gastropexy without fundoplication in patients with paraoesophageal hernia.

Details

Serval ID
serval:BIB_D7D694E97669
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Functional results after hiatal repair and gastropexy without fundoplication in patients with paraoesophageal hernia.
Journal
Langenbeck's archives of surgery
Author(s)
Bomio-Pacciorini L., Gaspar-Figueiredo S., Mantziari S., Godat S., Schäfer M., Teixeira Farinha H.
ISSN
1435-2451 (Electronic)
ISSN-L
1435-2443
Publication state
Published
Issued date
03/05/2024
Peer-reviewed
Oui
Volume
409
Number
1
Pages
150
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Paraoesophageal hernias (PEH) are associated with a high complication rate and often occur in elderly and fragile patients. Surgical gastropexy without fundoplication is an accepted alternative procedure; however, outcomes and functional results are rarely described. Our study aims to evaluate short-term outcomes and the long-term quality of life after gastropexy as treatment for PEH.
Single center cohort analysis of all consecutive patients who underwent gastropexy for PEH without fundoplication. Postoperative outcomes and functional results were retrospectively collected. Reflux symptoms developed postoperatively were reported using the validated quality of life questionnaire: GERD-Health Related Quality of Life Qestionnaire (GERD-HRQL).
Thirty patients (median age: 72 years (65-80)) were included, 40% classified as ASA III. Main PEH symptoms were reflux (63%), abdominal/thoracic pain (47%), pyrosis (33%), anorexia (30%), and food blockage (26%). Twenty-six laparoscopies were performed (86%). Major complications (III-IVb) occurred in 9 patients (30%). Seven patients (23%) had PEH recurrence, all re-operated, performing a new gastropexy. Median follow-up was 38 (17-50) months. Twenty-two patients (75%) reported symptoms resolution with median GERD-HRQL scale of 4 (1-6). 72% (n = 21) reported operation satisfaction. GERD-HRQL was comparable between patients who were re-operated for recurrence and others: 5 (2-19) versus 3 (0-6), p = 0.100.
Gastropexy without fundoplication was performed by laparoscopy in most cases with acceptable complications rates. Two-thirds of patients reported symptoms resolution, and long-term quality-of-live associated to reflux symptoms is good. Although the rate of PEH recurrence requiring a new re-intervention remained increased (23%), it does not seem to affect long-term functional results.
Keywords
Humans, Hernia, Hiatal/surgery, Female, Male, Aged, Quality of Life, Aged, 80 and over, Retrospective Studies, Gastropexy/methods, Treatment Outcome, Herniorrhaphy/methods, Herniorrhaphy/adverse effects, Fundoplication/methods, Fundoplication/adverse effects, Postoperative Complications/etiology, Gastroesophageal Reflux/surgery, Laparoscopy/adverse effects, Laparoscopy/methods, Cohort Studies, Recurrence, Gastroesophageal reflux disease (GERD), Gastropexy, Hiatal Hernia, Paraoesophageal Hernia, Quality-of-life (QoL)
Pubmed
Open Access
Yes
Create date
10/05/2024 15:32
Last modification date
11/05/2024 8:44
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