Repair of paraesophageal hernias.
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.
Horgan
S
S
Department of Surgery, University of Washington Seattle, 98195, USA.
Eubanks
T R
TR
Jacobsen
G
G
Omelanczuk
P
P
Pellegrini
C A
CA
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