Review of outcome after laparoscopic paraesophageal hiatal hernia repair.
Many studies have confirmed the effectiveness of laparoscopic paraesophageal hernia repair, but there are reports of high recurrence rates after surgery. We have conducted a review of the literature to determine whether it is a safe and durable procedure. A literature search was performed to identify all papers relevant to laparoscopic paraesophageal hernia repair. Twenty studies met the inclusion criteria for this review. In total, 1415 patients underwent attempted repair (mean age 65.7 y) of which 94% underwent an antireflux procedure. There were 70 (5.3%) episodes of operative morbidity and 173 (12.7%) patients experienced postoperative complications. In 10 studies, radiologic follow-up was offered after a mean of 16.5 months. Of those undergoing contrast swallow 26.9% had evidence of anatomic recurrence. In conclusion, recurrence rates after laparoscopic repair seem to be high compared with earlier studies of open repair. The long-term consequences of anatomic recurrence are currently uncertain.
Mehta
Sam
S
Department of Upper Gastrointestinal Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
Boddy
Alex
A
Rhodes
Michael
M
D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D012008:Recurrence; D013526:Surgical Mesh; D016896:Treatment Outcome