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Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals.
Surg Innov 2019; :1553350619869449SI

Abstract

The TIF (transoral incisionless fundoplication) 2.0 procedure is indicated for patients with a hiatal hernia less than 2 cm. Many patients with gastroesophageal reflux disease (GERD) require hiatal hernia repair. This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months.

Results.

Ninety-nine patients were enrolled, and all were symptomatic on PPI medications with hiatal hernias between 2 and 5 cm. Overall baseline GERD-HRQL scores indicated daily bothersome symptoms. At 12-month follow-up, median GERD-HRQL scores improved by 17 points, indicating that subjects had no bothersome symptoms. The median GERSS scores decreased from 25.0 at baseline to 1.0 and 90% of subjects reported having effective symptom control (score <18) at 12 months. Seventy-seven percent of subjects reported effective control of laryngopharyngeal reflux (LPR) symptoms at 12 months with an RSI score of 13 or less. At 12 months, 74% of subjects reported that they were not using proton pump inhibitors. All measures were statistically improved at P < .05. There were no adverse effects reported.

Conclusion.

HH + TIF provides significant symptom control for heartburn and regurgitation with no long-term dysphagia or gas bloat normally associated with traditional antireflux procedures. Most patients reported durable symptom control and satisfaction with health condition at 12 months.

Authors+Show Affiliations

Affinity Health Systems Appleton, Chilton, WI, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.Methodist Hospitals, Merrillville, IN, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31431138

Citation

Janu, Peter, et al. "Laparoscopic Hiatal Hernia Repair Followed By Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals." Surgical Innovation, 2019, p. 1553350619869449.
Janu P, Shughoury AB, Venkat K, et al. Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals. Surg Innov. 2019.
Janu, P., Shughoury, A. B., Venkat, K., Hurwich, D., Galouzis, T., Siatras, J., ... Mavrelis, P. (2019). Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals. Surgical Innovation, p. 1553350619869449. doi:10.1177/1553350619869449.
Janu P, et al. Laparoscopic Hiatal Hernia Repair Followed By Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals. Surg Innov. 2019 Aug 20;1553350619869449. PubMed PMID: 31431138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals. AU - Janu,Peter, AU - Shughoury,Ahmad Bassel, AU - Venkat,Kumar, AU - Hurwich,Daniel, AU - Galouzis,Tom, AU - Siatras,James, AU - Streeter,Dennis, AU - Korman,Kathleen, AU - Mavrelis,George, AU - Mavrelis,Peter, Y1 - 2019/08/20/ PY - 2019/8/23/pubmed PY - 2019/8/23/medline PY - 2019/8/22/entrez KW - TIF KW - esophageal surgery KW - evidence based medicine/surgery KW - flexible endoscopy KW - gastric surgery KW - hiatal hernia repair KW - interventional endoscopy KW - transoral incisionless fundoplication SP - 1553350619869449 EP - 1553350619869449 JF - Surgical innovation JO - Surg Innov N2 - The TIF (transoral incisionless fundoplication) 2.0 procedure is indicated for patients with a hiatal hernia less than 2 cm. Many patients with gastroesophageal reflux disease (GERD) require hiatal hernia repair. This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months. Results. Ninety-nine patients were enrolled, and all were symptomatic on PPI medications with hiatal hernias between 2 and 5 cm. Overall baseline GERD-HRQL scores indicated daily bothersome symptoms. At 12-month follow-up, median GERD-HRQL scores improved by 17 points, indicating that subjects had no bothersome symptoms. The median GERSS scores decreased from 25.0 at baseline to 1.0 and 90% of subjects reported having effective symptom control (score <18) at 12 months. Seventy-seven percent of subjects reported effective control of laryngopharyngeal reflux (LPR) symptoms at 12 months with an RSI score of 13 or less. At 12 months, 74% of subjects reported that they were not using proton pump inhibitors. All measures were statistically improved at P < .05. There were no adverse effects reported. Conclusion. HH + TIF provides significant symptom control for heartburn and regurgitation with no long-term dysphagia or gas bloat normally associated with traditional antireflux procedures. Most patients reported durable symptom control and satisfaction with health condition at 12 months. SN - 1553-3514 UR - https://www.unboundmedicine.com/medline/citation/31431138/Laparoscopic_Hiatal_Hernia_Repair_Followed_by_Transoral_Incisionless_Fundoplication_With_EsophyX_Device_(HH_+_TIF):_Efficacy_and_Safety_in_Two_Community_Hospitals L2 - http://journals.sagepub.com/doi/full/10.1177/1553350619869449?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -