• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Symptomatic and Radiographic Outcomes After Biologic Mesh Repair for Paraesophageal Hernia Repair

Thomas Wade, MD, Mary Quasebarth, Sara Baalman, L. Michael Brunt, MD. Washington University in St Louis

Introduction. The use of biologic mesh repair during laparoscopic paraesophageal hernia (PEH) repair has been associated with lower recurrence rate at 6 months but an increased recurrence rate up to 5 years after surgery. Few studies have correlated symptomatic outcomes and radiographic recurrences at or beyond one year follow-up. The purpose of this study was to evaluate patient centered outcomes and the rate of recurrent hiatal hernia ≥1 year after PEH repair with biologic mesh.

Methods and Procedures. A retrospective review of all primary PEH repairs with biologic mesh by one surgeon from 2003 to August 2013 was performed. All PEH repairs were performed with primary sutured cruroplasty with a biologic mesh buttress. Esophageal lengthening using a wedge fundectomy was performed selectively for short esophagus. Standardized symptom score sheets were completed pre-operatively and at follow-up visits for 5 GERD-related symptoms (dysphagia liquids, dysphagia solids, heartburn, chest pain, regurgitation); scoring used a composite of frequency and severity of symptoms on a 5 point Likert scale (maximum score 80). Barium esophagram was performed in all patients at one year and subsequently as clinically indicated. Data are mean ±SD and statistical analysis is by non-paired students t test.

Results. Primary PEH repairs with biologic mesh were performed in 138 patients; esophageal lengthening was performed in 50 of these cases (48%). One year barium swallow was completed in 104 patients (75.4%) Fourteen of 104 patients (13%) had evidence of recurrent hernia on barium swallow within the first year. An additional 16/104 (15%) patients had a recurrent hernia on barium swallow at 2-5 years post operation. Symptom score sheets were completed at 1 year or more after the operation in 74/104 (71%) patients. The average symptom score preoperatively was 8.5; at one year postoperatively it was 3.6± 9.8 for patients without radiologic recurrence and 1.0± 1.3 for those with a radiologic recurrence (p=0.91). Patients who developed a recurrent hernia at 2-5 years had a mean symptom score at 1 year of 7.3±17.1 compared to 2.0±5.5 in patients who did not develop recurrence (p<0.11). Most recurrent hernias were small (2cm) and only 4 patients (3.8%) required reoperation over a mean follow-up period of 24 months.

Conclusions. Recurrent hiatal hernia is common after PEH repair but most do not require reoperation. Symptom scores did not correlate with radiologic recurrence of PEH at one year. However, patients with increased symptom scores at 1 year follow up may be more likely develop a recurrent hernia at 2-5 years. These patients may benefit from more frequent follow-up and imaging.

89

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube
  • Instagram
  • TikTok

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons