title: Feasibility, safety, and short-term efficacy of the laparoscopic Nissen-Hill hybrid repair.
abstract: BACKGROUND
  A novel antireflux procedure combining laparoscopic Nissen fundoplication and Hill repair components was tested in 50 patients with paraesophageal hernia (PEH) and/or Barrett's esophagus (BE) because these two groups have been found to have a high rate of recurrence with conventional repairs.
  
  
  METHODS
  Patients with symptomatic PEH and/or non-dysplastic BE underwent repair. Quality of life (QOL) metrics, manometry, EGD, and pH testing were administered pre- and postoperatively.
  
  
  RESULTS
  Fifty patients underwent repair. There was no mortality and four major complications. At 13-month follow-up, there was one (2%) clinical recurrence, and two (4%) asymptomatic fundus herniations. Mean DeMeester scores improved from 57.2 to 7.7 (p < 0.0001). Control of preoperative symptoms was achieved in 90% with 6% resumption of antisecretory medication. All QOL metrics improved significantly.
  
  
  CONCLUSIONS
  The hybrid Nissen-Hill repair for patients with PEH and BE appears safe and clinically effective at short-term follow-up. It is hoped that the combined structural components may reduce the rate of recurrence compared to existing repairs.
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA. Ralph.Aye@swedish.org.
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Aye
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA.
authors.forename: Alia P
authors.initials: AP
authors.lastname: Qureshi
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA.
authors.forename: Candice L
authors.initials: CL
authors.lastname: Wilshire
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Farivar
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Vallières
authors.affiliation: Division of Thoracic Surgery, Swedish Cancer Institute and Medical Center, Seattle, WA, 98104, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Louie
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome
keywords: Antireflux surgery; Barrett’s metaplasia; Laparoscopic; Minimally invasive; Paraesophageal hernia repair