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Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese.

Publication ,  Journal Article
Kasotakis, G; Mittal, SK; Sudan, R
Published in: JSLS
2011

INTRODUCTION: Repair of large paraesophageal hernias by itself is associated with high failure rates in the morbidly obese. A surgical approach addressing both giant paraesophageal hernia and morbid obesity has, to our knowledge, not been explored in the surgical literature. METHODS: A retrospective review of a bariatric surgery database identified patients who underwent simultaneous repair of large type 3 paraesophageal hernias with primary crus closure and Roux-en-Y gastric bypass (RYGB). Operative time, intraoperative and 30-day morbidity, weight loss, resolution of comorbid conditions and use of antireflux medication were outcome measures. Integrity of crural closure was studied with a barium swallow. RESULTS: Three patients with a mean body mass index of 46kg/m(2) and mean age of 46 years underwent repair of a large paraesophageal hernia, primary crus closure, and RYGB. Mean operative time was 241 minutes and length of stay was 4 days. There was no intraoperative or 30-day morbidity. One patient required endoscopic balloon dilatation of the gastrojejunostomy. At 12 months, all patients were asymptomatic with excellent weight loss and resolution of comorbidities. Contrast studies showed no recurrence of the hiatal hernia. CONCLUSION: Simultaneous laparoscopic repair of large paraesophageal hernias in the morbidly obese is safe and effective.

Duke Scholars

Published In

JSLS

DOI

ISSN

1086-8089

Publication Date

2011

Volume

15

Issue

2

Start / End Page

188 / 192

Location

United States

Related Subject Headings

  • Surgical Procedures, Operative
  • Surgery
  • Retrospective Studies
  • Obesity, Morbid
  • Middle Aged
  • Laparoscopy
  • Humans
  • Hernia, Hiatal
  • Gastric Bypass
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Kasotakis, G., Mittal, S. K., & Sudan, R. (2011). Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese. JSLS, 15(2), 188–192. https://doi.org/10.4293/108680811X13022985132164
Kasotakis, George, Sumeet K. Mittal, and Ranjan Sudan. “Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese.JSLS 15, no. 2 (2011): 188–92. https://doi.org/10.4293/108680811X13022985132164.
Kasotakis G, Mittal SK, Sudan R. Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese. JSLS. 2011;15(2):188–92.
Kasotakis, George, et al. “Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese.JSLS, vol. 15, no. 2, 2011, pp. 188–92. Pubmed, doi:10.4293/108680811X13022985132164.
Kasotakis G, Mittal SK, Sudan R. Combined treatment of symptomatic massive paraesophageal hernia in the morbidly obese. JSLS. 2011;15(2):188–192.

Published In

JSLS

DOI

ISSN

1086-8089

Publication Date

2011

Volume

15

Issue

2

Start / End Page

188 / 192

Location

United States

Related Subject Headings

  • Surgical Procedures, Operative
  • Surgery
  • Retrospective Studies
  • Obesity, Morbid
  • Middle Aged
  • Laparoscopy
  • Humans
  • Hernia, Hiatal
  • Gastric Bypass
  • Female