Laparoscopic Roux-en-Y gastric bypass for treatment of symptomatic paraesophageal hernia in the morbidly obese: medium-term results

Chaudhry, Umer I.; Marr, Brendan; Osayi, Sylvester N.; Mikami, Dean J.; Needleman, Bradley J.; Melvin, W. Scott; Perry, Kyle A.

doi:10.1016/j.soard.2014.02.004

Cited by 25 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings are consistent with those of a 2014 study by Chaudhry et al of 14 obese patients undergoing RYGB for symptomatic PEH, which demonstrated comparable complication rates, weight loss, and symptom relief, suggesting the safety and success of such an operation [19]. Their study also included quality of life (QoL) metrics and determined a 78% good to excellent QoL on the GERD health-related QoL questionnaire.…”

Section: Discussionsupporting

confidence: 91%

Feasibility of Anti-reflux Gastric Bypass for Massive Paraesophageal Hernia in Obese Patients With Gastroesophageal Reflux Disease

Kayastha,

Wasselle,

Wilensky

et al. 2023

Cureus

View full text Add to dashboard Cite

BackgroundThe objective of this study is to demonstrate the safety and feasibility of anti-reflux gastric bypass (ARGB) as a treatment for symptomatic massive paraesophageal hernias (PEH) in the obese population. Both gastroesophageal reflux disease (GERD) and PEH are particularly prevalent in the obese patient population, and obesity adversely affects the long-term outcomes of all anti-reflux procedures. MethodsThis is a single-center, retrospective review of 17 obese adults who underwent ARGB for the treatment of massive PEH between September 2019 and December 2021. Massive PEH was defined as >5 cm in a singular direction, and obesity as BMI ≥30 kg/m 2 . Patients without preoperative diagnostic testing were excluded. We reviewed and analyzed patient demographic data, postoperative symptom resolution, weight loss, and complications using descriptive statistics, change from baseline, and comparison of proportions. ResultsSixteen of the 17 subjects were female. The median age was 48, and the median BMI was 39.10 kg/m 2 (30.0-49.3 kg/m 2 ). The average PEH size on imaging was 6.48 (H) x 6.25 (W) cm. The resolution of heartburn was 93.8% (p<0.001), and the resolution of nausea and vomiting was 80.0%. The mean postoperative length of follow-up was 9.12 months. Median excess body weight loss percentages at one, three, six, and 12 months were 16.43% (p<0.001), 35.92% (p<0.001), 40.64% (p=0.001), and 58.58% (p<0.01), respectively. Five patients experienced adverse events requiring additional intervention or hospitalization. There were no symptomatic hernia recurrences or mortality. ConclusionThis study demonstrates that ARGB is feasible and potentially effective in treating symptomatic massive paraesophageal hernias in the obese patient population. Further investigation is needed to determine efficacy and long-term outcomes compared to standard surgical repair.

show abstract

Section: Discussionsupporting

confidence: 91%

Feasibility of Anti-reflux Gastric Bypass for Massive Paraesophageal Hernia in Obese Patients With Gastroesophageal Reflux Disease

Kayastha,

Wasselle,

Wilensky

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Morgenthal et al 28 demonstrated that patients with morbid obesity (BMI >35) were more likely to experience treatment failure after laparoscopic Nissen fundoplication, although their series did not include patients with PEH. Other authors 29,30 have shown differing results, and more surgeons currently are offering morbidly obese patients concurrent bariatric surgery (sleeve gastrectomy or Roux-en-Y gastric bypass) at the time of PEH repair. The proponents of this approach 31 imply that the weight reduction that accompanies bariatric surgery will lower the recurrence rate of PEH in these patients in addition to providing the benefit that inheres as a result of the well-documented improvement of obesity-related comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Long-term Quality of Life and Risk Factors for Recurrence After Laparoscopic Repair of Paraesophageal Hernia

et al. 2015

View full text Add to dashboard Cite

show abstract

“…However, a study by Kothari et al reported that combined HHR and LRYGB is associated with no increase in the 30-day mortality and morbidity when compared to LRYGB alone [ 15 ]. Furthermore, a study reported improvement in GORD-Related Quality of Life (GORD-HRQL) scores and in the use of anti-reflux medications when combining LRYGB with HHR [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Concurrent Hiatus Hernia Repair with Different Bariatric Surgery Procedures: a Systematic Review and Meta-analysis

Mills,

Alhindi,

Idris

et al. 2023

OBES SURG

View full text Add to dashboard Cite

Background Hiatus hernia (HH) is prevalent among patients with obesity. Concurrent repair is often performed during metabolic and bariatric surgery (MBS), but a consensus on the safety and effectiveness of concurrent HH repair (HHR) and MBS remains unclear. We performed a systematic review of the safety and effectiveness of concurrent HHR and MBS through the measurement of multiple postoperative outcomes. Method Seventeen studies relating to concurrent MBS and HHR were identified. MBS procedures included laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (LRYGB), and adjustable gastric banding (LAGB). Studies with pre- and postoperative measurements and outcomes were extracted. Results For LSG, 9 of 11 studies concluded concurrent procedures to be safe and effective with no increase in mortality. Reoperation and readmission rates however were increased with HHR, whilst GORD rates were seen to improve, therefore providing a solution to the predominant issue with LSG. For LRYGB, in all 5 studies, concurrent procedures were concluded to be safe and effective, with no increase in mortality, length of stay, readmission and reoperation rates. Higher complication rates were observed compared to LSG with HHR. Among LAGB studies, all 4 studies were concluded to be safe and effective with no adverse outcomes on mortality and length of stay. GORD rates were seen to decrease, and reoperation rates from pouch dilatation and gastric prolapse were observed to significantly decrease. Conclusion Concurrent HHR with MBS appears to be safe and effective. Assessment of MBS warrants the consideration of concurrent HHR depending on specific patient case and the surgeon’s preference. Graphical Abstract

show abstract

Laparoscopic Roux-en-Y gastric bypass for treatment of symptomatic paraesophageal hernia in the morbidly obese: medium-term results

Cited by 25 publications

References 17 publications

Feasibility of Anti-reflux Gastric Bypass for Massive Paraesophageal Hernia in Obese Patients With Gastroesophageal Reflux Disease

Feasibility of Anti-reflux Gastric Bypass for Massive Paraesophageal Hernia in Obese Patients With Gastroesophageal Reflux Disease

Long-term Quality of Life and Risk Factors for Recurrence After Laparoscopic Repair of Paraesophageal Hernia

Outcomes of Concurrent Hiatus Hernia Repair with Different Bariatric Surgery Procedures: a Systematic Review and Meta-analysis

Contact Info

Product

Resources

About