Treatment and Controversies in Paraesophageal Hernia Repair
Open Access
- 20 April 2015
- journal article
- review article
- Published by Frontiers Media SA in Frontiers in Surgery
- Vol. 2, 13
- https://doi.org/10.3389/fsurg.2015.00013
Abstract
Background: Historically all paraesophageal hernias were repaired surgically, today intervention is reserved for symptomatic paraesophageal hernias. In this review, we describe the indications for repair and explore the controversies in paraesophageal hernia repair, which include a comparison of open to laparoscopic paraesophageal hernia repair, the necessity of complete sac excision, the routine performance of fundoplication, and the use of mesh for hernia repair. Methods: We searched Pubmed for papers published between 1980 and 2015 using the following keywords: hiatal hernias, paraesophageal hernias, regurgitation, dysphagia, gastroesophageal reflux disease, aspiration, GERD, endoscopy, manometry, pH monitoring, proton pump inhibitors, anemia, iron deficiency anemia, Nissen fundoplication, sac excision, mesh, mesh repair. Results: Indications for paraesophageal hernia repair have changed, and currently symptomatic paraesophageal hernias are recommended for repair. In addition, it is important not to overlook iron-deficiency anemia and pulmonary complaints, which tend to improve with repair. Current practice favors a laparoscopic approach, complete sac excision, primary crural repair with or without use of mesh, and a routine fundoplication.This publication has 34 references indexed in Scilit:
- Biologic Prosthesis to Prevent Recurrence after Laparoscopic Paraesophageal Hernia Repair: Long-term Follow-up from a Multicenter, Prospective, Randomized TrialJournal of the American College of Surgeons, 2011
- Laparoscopic versus Open Repair of Paraesophageal Hernia: The Second DecadeJournal of the American College of Surgeons, 2011
- Laparoscopic Repair of Paraesophageal HerniaAnnals of Surgery, 2011
- Tailored or Routine Addition of an Antireflux Fundoplication in Laparoscopic Large Hiatal Hernia Repair: A Comparative Cohort StudyWorld Journal of Surgery, 2010
- Outcomes after a decade of laparoscopic giant paraesophageal hernia repairThe Journal of Thoracic and Cardiovascular Surgery, 2010
- Controversies in paraesophageal hernia repair; a review of literatureSurgical Endoscopy, 2005
- Symptomatic and radiological follow-up after para-esophageal hernia repairDiseases of the Esophagus, 2004
- Should laparoscopic paraesophageal hernia repair be abandoned in favor of the open approach?Surgical Endoscopy, 2004
- Simple laparoscopic gastropexy as the initial treatment of paraoesophageal hiatal herniaBritish Journal of Surgery, 1998
- Hiatus HerniaAnnals of Surgery, 1973