title: Experience of laparoscopic paraesophageal hernia repair at a single institution.
abstract: BACKGROUND
  Paraesophageal hernia patients are often elderly with complicating medical comorbidities, making surgical management complex in formulating a management strategy.
  
  
  METHODS
  Between January 2005 and July 2009, 93 patients underwent surgical treatment of paraesophageal hernia, including 8 recurrent cases after multiple repairs. Open transabdominal surgeries were performed in 14 (15%) patients, and combined thoracotomy was performed in 1 (1%). Laparoscopic surgeries were performed in 78 (84%) patients with 4 (5%) conversions. Artificial prosthetics were used in 27 (29%) patients. Fundoplication was performed in 82 (88%) patients. Gastropexy or feeding tube gastrostomy was performed in 10 (11%) patients.
  
  
  RESULTS
  The average length of the surgery was 125 minutes (range, 51-304 min). The mean blood loss was 100 mL. The average length of stay was 4 days (range, 1-14 d). There were 2 mortalities (2%) and 4 re-operations, with a recurrence rate of 2%.
  
  
  CONCLUSIONS
  Laparoscopic paraesophageal hernia repair can be performed safely with acceptable results when following a standard approach.
authors: Section of Minimally Invasive Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA.
authors: Jihui
authors: J
authors: Li
authors: Raul J
authors: RJ
authors: Rosenthal
authors: Mayank
authors: M
authors: Roy
authors: Samuel
authors: S
authors: Szomstein
authors: Mark
authors: M
authors: Sesto
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005431:Florida; D018662:Fundoplication; D059485:Gastropexy; D005774:Gastrostomy; D006551:Hernia, Hiatal / Q000401:mortality / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D013526:Surgical Mesh / Q000706:statistics & numerical data; D013908:Thoracotomy; D016896:Treatment Outcome; D014945:Wound Healing