Concomitant hiatal hernia repair during bariatric surgery: does the reinforcement make the difference?

Bariatric Surgery Hernia, Hiatal / surgery Herniorrhaphy Humans Laparoscopy Retrospective Studies

Journal

Minerva surgery
ISSN: 2724-5438
Titre abrégé: Minerva Surg
Pays: Italy
ID NLM: 101777295

Informations de publication

Date de publication:
02 2021
Historique:
pubmed: 3 10 2020
medline: 29 10 2021
entrez: 2 10 2020
Statut: ppublish

Résumé

Hiatal hernia repair (HHR) is still controversial during bariatric procedures, especially in case of laparoscopic sleeve gastrectomy (LSG). to report the long-term results of concomitant HHR, evaluating the safety and efficacy of posterior cruroplasty (PC), simple or reinforced with biosynthetic, absorbable Bio-A The prospective database of 1876 bariatric operations performed in a center of excellence between 2011-2019 was searched for concomitant HHR. Intraoperative measurement of the hiatal surface area (HSA) was performed routinely. A total of 250 patients undergone bariatric surgery and concomitant HHR (13%). Simple PC (group A, 151 patients) was performed during 130 LSG, 5 re-sleeves and 16 gastric bypasses; mean BMI 43.4±5.8 kg/m An aggressive search for and repair of HH during any bariatric procedure seems advisable, allowing a low HH recurrence rates. Additional measures, like mesh reinforcement of crural closure with biosynthetic, absorbable mesh, seem to improve results on long term follow-up, especially in case of larger hiatal defects. In our experience, reinforcement of even smaller defects seems advisable in obese population.

Sections du résumé

BACKGROUND
Hiatal hernia repair (HHR) is still controversial during bariatric procedures, especially in case of laparoscopic sleeve gastrectomy (LSG).
AIMS
to report the long-term results of concomitant HHR, evaluating the safety and efficacy of posterior cruroplasty (PC), simple or reinforced with biosynthetic, absorbable Bio-A
METHODS
The prospective database of 1876 bariatric operations performed in a center of excellence between 2011-2019 was searched for concomitant HHR. Intraoperative measurement of the hiatal surface area (HSA) was performed routinely.
RESULTS
A total of 250 patients undergone bariatric surgery and concomitant HHR (13%). Simple PC (group A, 151 patients) was performed during 130 LSG, 5 re-sleeves and 16 gastric bypasses; mean BMI 43.4±5.8 kg/m
CONCLUSIONS
An aggressive search for and repair of HH during any bariatric procedure seems advisable, allowing a low HH recurrence rates. Additional measures, like mesh reinforcement of crural closure with biosynthetic, absorbable mesh, seem to improve results on long term follow-up, especially in case of larger hiatal defects. In our experience, reinforcement of even smaller defects seems advisable in obese population.

Identifiants

DOI: 10.23736/S2724-5691.20.08503-X PMID: 33006451
pubmed: 33006451
pii: S0026-4733.20.08503-X
doi: 10.23736/S2724-5691.20.08503-X
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

33-42

Auteurs

Cristian E Boru (CE)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy - drcrisb@gmail.com.

Pietro Termine (P)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Pavlos Antypas (P)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Angelo Iossa (A)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Chiara M Ciccioriccio (CM)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Francesco DE Angelis (F)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Alessandra Micalizzi (A)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Gianfranco Silecchia (G)

Division of General Surgery and Bariatric Center of Excellence-IFSO EC, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

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Classifications MeSH

questionsmedicales.fr › Procédures de chirurgie opératoire › Chirurgie bariatrique › Concomitant hiatal hernia repair during...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Hernie › Hernie interne › Hernie diaphragmatique › Hernie hiatale › Concomitant hiatal hernia repair during...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie reconstructive › Herniorraphie › Concomitant hiatal hernia repair during...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Concomitant hiatal hernia repair during...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Laparoscopie › Concomitant hiatal hernia repair during...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Concomitant hiatal hernia repair during...