Patient-tailored algorithm for laparoscopic cruroplasty standardization: comparison with hiatal surface area and medium-term outcomes
| Autor: | Alberto Aiolfi, Andrea Sozzi, Marta Cavalli, Gianluca Bonitta, Cristina Ogliari, Francesca Lombardo, Alessio Lanzaro, Piero Giovanni Bruni, Giampiero Campanelli, Davide Bona |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Hernia Adolescent Crural repair Laparoscopic hiatus hernia repair Mesh Phasix-ST Toupet fundoplication Aged Aged 80 and over Algorithms Herniorrhaphy Humans Middle Aged Quality of Life Recurrence Reference Standards Reproducibility of Results Retrospective Studies Surgical Mesh Treatment Outcome Gastroesophageal Reflux Hernia Hiatal Laparoscopy 80 and over Hiatal Surgery |
| Zdroj: | Langenbeck's archives of surgery. 407(6) |
| ISSN: | 1435-2451 |
| Popis: | Different methods have been described for laparoscopic hiatoplasty and hiatus hernia (HH) repair. All techniques are not standardized and the choice to reinforce or not the hiatus with a mesh is left to the operating surgeon's preference. Hiatal surface area (HSA) has been described as an attempt at standardization; in case the area is4 cmThe aim of this study was to describe a new patient-tailored algorithm (PTA), compare its performance in predicting crura mesh buttressing to HSA, and analyze outcomes.Retrospective, single-center, descriptive study (September 2018-September 2021). Adult patients (≥ 18 years old) who underwent laparoscopic HH repair. Outcomes and quality of life measured with the disease-specific gastroesophageal reflux disease health-related quality of life (GERD-HRQL) and reflux symptom index (RSI) were analyzed.Fifty patients that underwent laparoscopic hiatoplasty and Toupet fundoplication were included. The median age was 61 years (range 32-83) and the median BMI was 26.7 (range 17-36). According to the PTA, 27 patients (54%) underwent simple suture repair while crural mesh buttressing with Phasix-ST® was used in 23 (46%). According to the HSA, the median hiatus area was 4.7 cmThe application of PTA for cruroplasty standardization in the setting of HH repair seems effective. While concordance with HSA is high, the PTA seems easier and promptly available in the operative theater with a potential increase in procedure standardization, reproducibility, and teaching. |
| Databáze: | OpenAIRE |
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