Background: Recurrence and reflux are 2 most important remote complications of lap-paraesophageal hernia (PEH) repair. However, the extent of recurrence remains unknown. We sought to determine the true incidence of recurrence after lap-PEH repair.
Methods: A meta-analysis was carried out. PubMed, EMBASE, Cochrane Library, hand search, and personal communication were used to access and appraise studies. The inclusion criteria were full-text papers published from 1991 to date that describe lap-PEH repair in >25 patients, have at least a 6-month follow-up, and address the issue of recurrence. "Wrap migration" papers were excluded. Papers were appraised and the data were isolated on summary sheets. MS Office Excel 2003 was used to plot the results and represent it in graphs.
Results: Thirteen studies were eligible (all retrospective case series). A total of 965 patients with 99 recurrences were noted. The overall recurrence rate (in all patients) was 10.2% and was 14% if only the followed up patients (n=658/965) were considered. However, when patients with objective evidence (follow-up Ba esophagogram) were used (301/965), the "true" recurrence rate was 25.5% (ie, 1 in 4 recurred). The learning curve did not appear to be an issue (P=0.27). The studies revealed broad 95 CI and touched the line-of-no-effect, thereby increasing the "chance factor." When an alternate model was applied, esophageal lengthening (by Collis-Nissen gastroplasty) revealed a significant protective influence (P<0.0001).
Conclusion: The true incidence of lap-PEH recurrence is 25.5%. The learning curve is not an adequate explanation. Mandatory (protocol) follow-up esophagograms at 1 year are essential. Two emphasis points in the repair have emerged: hiatoplasty and (superadded) esophageal lengthening.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015848 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Efficacy of tranilast in preventing exacerbating cardiac function and death from heart failure in muscular dystrophy patients with advanced-stage heart failure: a single-arm, open-label, multicenter study.
Orphanet J Rare Dis
January 2025
Department of Cardiac Physiology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
Background: Transient receptor potential cation channel subfamily V member 2 (TRPV2) functions as a stretch-sensitive calcium channel, with overexpression in the sarcolemma of skeletal and cardiac myocytes leading to detrimental calcium influx and triggering muscle degeneration. In our previous pilot study, we showed that tranilast, a TRPV2 inhibitor, reduced brain natriuretic peptide levels in two patients with muscular dystrophy and advanced heart failure. Building on this, we performed a single-arm, open-label, multicenter study herein to evaluate the safety and efficacy of tranilast in the treatment of advanced heart failure in patients with muscular dystrophy.
View Article and Find Full Text PDFEndoscopic retrograde cholangiopancreatography combined with extracorporeal shock wave lithotripsy for the removal of large gallbladder stones: a pilot study.
BMC Gastroenterol
January 2025
Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No.17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Background: Endoscopic gallbladder-preserving cholecystolithotomy (EGPC) has become an alternative option for treating cholecystolithiasis. However, developing a new method of EGPC in which the gallbladder wall is not damaged remains a challenge. This study introduced a new EGPC method called endoscopic retrograde cholangiopancreatography (ERCP) combined with extracorporeal shock wave lithotripsy (ESWL), which preserves the integrity of the gallbladder wall in the treatment of cholecystolithiasis complicated with choledocholithiasis.
View Article and Find Full Text PDFCircumferential nerve wrapping with muscle autograft: a modified strategy of microvascular decompression for trigeminal neuralgia.
Neurosurg Rev
January 2025
Department of Neurosurgery, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS, 86077, Italy.
Microvascular decompression is considered a first-line treatment in classical trigeminal neuralgia. Teflon is the material commonly used. The use of autologous muscle has been occasionally reported.
View Article and Find Full Text PDFImproved outcomes after groin hernia surgery in Sweden between 1992 and 2021: Swedish Hernia Register.
Hernia
January 2025
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Purpose: Surgery for groin hernia is one of the most common operations in the world. Therefore, research concerning the outcomes of groin hernia surgery is extremely important both for the individual patient as well as for those providing the healthcare funding. The aim of this study is to evaluate the outcomes of hernia surgery in Sweden over a 30 year time period, from 1992 to 2021.
View Article and Find Full Text PDFA retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience.
Brachytherapy
January 2025
Ocular Oncology and Radiology Department, S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia.
Purpose: To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.
Methods: We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (Ru or Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.
Results: Complete tumor control was achieved in 273 tumors (82%).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!