Long-term symptomatic outcome and radiologic assessment of laparoscopic hiatal hernia repair.
BACKGROUND
The long-term durability of laparoscopic repair of paraesophageal hiatal herniation is uncertain. This study focuses on the long-term symptomatic and radiologic outcome of laparoscopic paraesophageal herniation repair.


METHODS
Between 2000 and 2007, 70 patients (49 females, mean age +/- standard deviation 60.6 +/- 10.9 years) undergoing laparoscopic repair of paraesophageal herniation were studied prospectively. After a mean follow-up of 45.6 +/- 23.8 months, symptomatic (65 patients, 93%) and radiologic follow-up (60 patients, 86%) was performed by standardized questionnaires and esophagograms.


RESULTS
The symptomatic outcome was successful in 58 patients (89%), and gastroesophageal anatomy was intact in 42 patients (70%). The addition of a fundoplication was the only significant predictor of an unfavorable radiologic outcome in the univariate analysis (odds ratio .413; 95% confidence interval, .130 to 1.308; P = .125).


CONCLUSIONS
The long-term symptomatic outcome of laparoscopic repair of paraesophageal hiatal herniation was favorable in 89% of patients, and 70% had successful anatomic repair. The addition of a fundoplication did not prevent anatomic herniation.
Furnée
Edgar J B
EJ
Department of Surgery, University Medical Center, Utrecht, The Netherlands.
Draaisma
Werner A
WA
Simmermacher
Rogier K
RK
Stapper
Gerard
G
Broeders
Ivo A M J
IA
D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome