title: Impact on perioperative outcomes of concomitant hiatal hernia repair with laparoscopic gastric bypass.
abstract: BACKGROUND
  The role of laparoscopic hiatal hernia repair (LHHR) at the time of laparoscopic Roux-en-y gastric bypass (LRYGB) is still debatable. This study aims to assess the safety of concomitant LHHR with LRYGB.
  
  
  METHODS
  This study is a multi-center, retrospective analysis of a large administrative database. The University Health System Consortium (UHC) is a group of 112 academic medical centers and 256 of their affiliated hospitals. The UHC database was queried using International Classification of Diseases-9 codes and main outcome measures were analyzed.
  
  
  RESULTS
  From October 2006 to January 2010, we found 33,717 patients who underwent LRYGB and did not have a hiatal hernia. In this same time period, 644 patients underwent concomitant LRYGB and LHHR, while 1,589 patients underwent LRYGB without repair of their hiatal hernias. On comparison of patients undergoing LRYGB with simultaneous LHHR with those who underwent LRYGB without a diagnosis of HH, there was no significant difference in mortality, morbidity, length of stay (LOS), 30-day readmission, or cost shown. On comparison of patients with HH who underwent LRYGB and simultaneous LHHR with those who had LRYGB without LHHR, no significant difference with regards to all the outcome measures was also shown.
  
  
  CONCLUSIONS
  In conclusion, concomitant hiatal hernia repair with LRYGB appears to be safe and feasible. These patients did not have any significant differences in morbidity, mortality, LOS, readmission rate, or cost. Randomized controlled studies should further look into the benefit of hiatal hernia repair in regards to reflux symptoms and weight loss for LRYGB patients.
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA.
authors: Vishal
authors: V
authors: Kothari
authors: Abhijit
authors: A
authors: Shaligram
authors: Jason
authors: J
authors: Reynoso
authors: Elizabeth
authors: E
authors: Schmidt
authors: Corrigan L
authors: CL
authors: McBride
authors: Dmitry
authors: D
authors: Oleynikov
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006551:Hernia, Hiatal / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods*; D015995:Prevalence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology