title: Repair of paraesophageal hernias.
abstract: BACKGROUND
  Three years ago we proposed the use of laparoscopy and systematic addition of an antireflux procedure to repair paraesophageal hernias. We now present an analysis of the outcome on patients and the evolution of the technique proposed.
  
  
  METHODS
  Symptoms and esophageal function were prospectively collected and followed in 41 consecutive patients treated over a 4-year period. Indications for repair included chronic anemia in 15 patients, and previous incarceration in 8. Twenty-two patients had symptoms of reflux.
  
  
  RESULTS
  All operations were started laparoscopically, two were converted. Mean operating time was 210 minutes, and mean hospital stay was 4 days. Mean follow-up was 3 years. The operation was effective; all symptoms had improved significantly at last follow-up.
  
  
  CONCLUSIONS
  Laparoscopic repair of paraesophageal hernia with the addition of an antireflux procedure, although difficult, lengthy, and not totally without risk, improves symptoms substantially, resolves anemia, and prevents incarceration in nearly all patients.
authors.affiliation: Department of Surgery, University of Washington Seattle, 98195, USA.
authors.forename: S
authors.initials: S
authors.lastname: Horgan
authors.forename: T R
authors.initials: TR
authors.lastname: Eubanks
authors.forename: G
authors.initials: G
authors.lastname: Jacobsen
authors.forename: P
authors.initials: P
authors.lastname: Omelanczuk
authors.forename: C A
authors.initials: CA
authors.lastname: Pellegrini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005764:Gastroesophageal Reflux / Q000517:prevention & control / Q000601:surgery*; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome