Tags

Type your tag names separated by a space and hit enter

Long-term efficacy of laparoscopic Nissen versus Toupet fundoplication for the management of types III and IV hiatal hernias.
Surg Endosc. 2019 09; 33(9):2895-2900.SE

Abstract

BACKGROUND

Laparoscopic hiatal hernia repair via Toupet or Nissen fundoplication remains the most commonly performed procedures for management of large hiatal hernia. Few studies have compared the procedures' long-term effectiveness. This study sought to characterize the efficacy of laparoscopic Toupet versus Nissen fundoplication for types III and IV hiatal hernia.

METHODS

With IRB approval, a review of all laparoscopic hiatal hernia repairs with mesh reinforcement performed over 7 years at a single center by one surgeon was conducted. Hiatal hernias were classified as type III or IV using operative reports and preoperative imaging. Patients with type I, II, or recurrent hiatal hernia and patients receiving concomitant procedures were excluded. The GERD-Health Related Quality of Life Survey was administered by telephone no earlier than 18 months postoperatively.

RESULTS

A total of 473 patients underwent laparoscopic fundoplication; 179 having type III or IV hiatal hernia met inclusion criteria; 62 underwent Toupet, 117 underwent Nissen fundoplication. Average patient age was 64 years; 63% of patients were female. Cohorts were similar in demographics, comorbidities, and intraoperative factors. Survey was completed by 77 patients (43%): 50 having Nissen and 27 Toupet. Median time of survey completion after surgery was 54 months (Nissen) and 25 months (Toupet). Median survey responses across all items for both groups were 0 (no symptoms) with no significant variation between groups. Of patients that had Nissen, 26% reported current proton-pump inhibitor use versus 31% of Toupet patients (p = 0.486). Patient-reported satisfaction with current condition was similar between groups (67% Toupet, 72% Nissen, p = 0.351).

CONCLUSIONS

Patient-reported symptoms and satisfaction did not vary for patients receiving laparoscopic Nissen versus Toupet fundoplication, which may indicate that patients with large type III and IV hiatal hernia undergoing either procedure have similar long-term postoperative symptom control.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Huerta CT
University of Kentucky College of Medicine, Lexington, KY, USA.
Plymale M
Division of General Surgery, University of Kentucky, Lexington, KY, USA.
Barrett P
Division of General Surgery, University of Kentucky, Lexington, KY, USA.
Davenport DL
Department of Surgery, University of Kentucky, Lexington, KY, USA.
Roth JS
Division of General Surgery, University of Kentucky, Lexington, KY, USA. s.roth@uky.edu. Division of General Surgery, Department of Surgery, University of Kentucky College of Medicine, 800 Rose Street, C 225, Lexington, KY, 40536, USA. s.roth@uky.edu.

MeSH

AgedFemaleFollow-Up StudiesFundoplicationHernia, HiatalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedPatient SatisfactionPostoperative PeriodQuality of LifeTime FactorsTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30478698

Citation

Huerta, C Theodore, et al. "Long-term Efficacy of Laparoscopic Nissen Versus Toupet Fundoplication for the Management of Types III and IV Hiatal Hernias." Surgical Endoscopy, vol. 33, no. 9, 2019, pp. 2895-2900.
Huerta CT, Plymale M, Barrett P, et al. Long-term efficacy of laparoscopic Nissen versus Toupet fundoplication for the management of types III and IV hiatal hernias. Surg Endosc. 2019;33(9):2895-2900.
Huerta, C. T., Plymale, M., Barrett, P., Davenport, D. L., & Roth, J. S. (2019). Long-term efficacy of laparoscopic Nissen versus Toupet fundoplication for the management of types III and IV hiatal hernias. Surgical Endoscopy, 33(9), 2895-2900. https://doi.org/10.1007/s00464-018-6589-y
Huerta CT, et al. Long-term Efficacy of Laparoscopic Nissen Versus Toupet Fundoplication for the Management of Types III and IV Hiatal Hernias. Surg Endosc. 2019;33(9):2895-2900. PubMed PMID: 30478698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term efficacy of laparoscopic Nissen versus Toupet fundoplication for the management of types III and IV hiatal hernias. AU - Huerta,C Theodore, AU - Plymale,Margaret, AU - Barrett,Peter, AU - Davenport,Daniel L, AU - Roth,John Scott, Y1 - 2018/11/26/ PY - 2018/04/12/received PY - 2018/11/12/accepted PY - 2018/11/28/pubmed PY - 2020/5/6/medline PY - 2018/11/28/entrez KW - Dysphagia KW - Heartburn KW - Hiatal hernia KW - Long-term outcomes KW - Nissen fundoplication KW - Toupet fundoplication SP - 2895 EP - 2900 JF - Surgical endoscopy JO - Surg Endosc VL - 33 IS - 9 N2 - BACKGROUND: Laparoscopic hiatal hernia repair via Toupet or Nissen fundoplication remains the most commonly performed procedures for management of large hiatal hernia. Few studies have compared the procedures' long-term effectiveness. This study sought to characterize the efficacy of laparoscopic Toupet versus Nissen fundoplication for types III and IV hiatal hernia. METHODS: With IRB approval, a review of all laparoscopic hiatal hernia repairs with mesh reinforcement performed over 7 years at a single center by one surgeon was conducted. Hiatal hernias were classified as type III or IV using operative reports and preoperative imaging. Patients with type I, II, or recurrent hiatal hernia and patients receiving concomitant procedures were excluded. The GERD-Health Related Quality of Life Survey was administered by telephone no earlier than 18 months postoperatively. RESULTS: A total of 473 patients underwent laparoscopic fundoplication; 179 having type III or IV hiatal hernia met inclusion criteria; 62 underwent Toupet, 117 underwent Nissen fundoplication. Average patient age was 64 years; 63% of patients were female. Cohorts were similar in demographics, comorbidities, and intraoperative factors. Survey was completed by 77 patients (43%): 50 having Nissen and 27 Toupet. Median time of survey completion after surgery was 54 months (Nissen) and 25 months (Toupet). Median survey responses across all items for both groups were 0 (no symptoms) with no significant variation between groups. Of patients that had Nissen, 26% reported current proton-pump inhibitor use versus 31% of Toupet patients (p = 0.486). Patient-reported satisfaction with current condition was similar between groups (67% Toupet, 72% Nissen, p = 0.351). CONCLUSIONS: Patient-reported symptoms and satisfaction did not vary for patients receiving laparoscopic Nissen versus Toupet fundoplication, which may indicate that patients with large type III and IV hiatal hernia undergoing either procedure have similar long-term postoperative symptom control. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/30478698/Long_term_efficacy_of_laparoscopic_Nissen_versus_Toupet_fundoplication_for_the_management_of_types_III_and_IV_hiatal_hernias_ DB - PRIME DP - Unbound Medicine ER -