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首页> 外文期刊>Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract >Predictors of Hiatal Hernia Recurrence After Laparoscopic Anti-reflux Surgery with Hiatal Hernia Repair: a Prospective Database Analysis
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Predictors of Hiatal Hernia Recurrence After Laparoscopic Anti-reflux Surgery with Hiatal Hernia Repair: a Prospective Database Analysis

机译：腹腔镜抗流术后腹腔镜疝抗流术后疝疝疝修复的预测因素：预期数据库分析

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BackgroundThe aim of this study is to identify factors that can predict hiatal hernia recurrence (HHR) in patients after anti-reflux surgery with hiatal hernia (HH) repair.MethodsA single-institution, prospectively collected database was reviewed (January 2002-October 2015) with inclusion criteria of GERD and laparoscopic anti-reflux (AR) surgery with HH repair. Demographics, esophageal symptom scores, and pre- and post-upper gastrointestinal imaging (UGI) were collected. Mesh usage, HH type (sliding, paraesophageal (HH) or type IV), and size were evaluated, and patients who had HHR versus those who did not (NHHR) were compared. Statistical analysis was performed using IBM SPSS v.23.0.0, with =0.05.ResultsThree hundred twenty-two patients met inclusion criteria. Mean age was 56.914.8years (60.9% female), and mean follow-up was 19.9 +/- 23.8months. 88.2% underwent total fundoplication and 11.8% underwent partial fundoplication. HHR rate was 15.5%. HHR patients had larger HH than the NHHR group. There was no significant difference between groups for age, gender, BMI, race, and mesh usage. Only 3 patients (10.3%) with HHR reported mild-to-moderate heartburn, regurgitation, and solid or liquid dysphagia at 12-month follow-up. Overall reoperation rate was 1% in this population.Conclusions HHR is correlated with large hernia size. Mesh use and patient BMI were not predictors, and no correlation was identified between HHR and presence of GERD symptoms. Recurrence after repair is not uncommon, but is asymptomatic in most cases. Reoperation is rare and mesh is not routinely needed. Large asymptomatic HHs in the elderly often do not require intervention.
机译：背景技术本研究的目的是识别可以预测抗回患者患者的患者HEATAL HERNIA复发（HHR）的因素，患有海拔Hernia（HH）修复。审查了预计的数据库（2015年1月）的预计数据库（2015年1月）随着GERD和腹腔镜抗反流（AR）手术的纳入标准，HH修复。收集人口统计，食管症状评分和预先胃肠道成像（UGI）。对网格使用，HH型（滑动，审美食管（HH）或IV型）和尺寸进行了评估，并且比较了HHR与那些没有（NHHR）的人的患者。使用IBM SPSS v.23.0.0进行统计分析，= 0.05.Resulttree百年患者符合纳入标准。平均年龄为56.914.8年（女性60.9％），平均随访19.9 +/- 23.8个月。 88.2％的总青铜精神和11.8％的部分基础强制案。 HHR率为15.5％。 HHR患者比NHHR组更大。年龄，性别，BMI，种族和网格使用中没有显着差异。只有3名患者（10.3％），HHR报道了12个月随访的温和至中度胃灼热，反流和固体或液体吞咽症。本人的总体再生率为1％。结论HHR与大的疝气大小相关。网状使用和患者BMI不是预测因子，并且在HHR和GER​​D症状的存在下没有鉴定相关性。修复后复发并不少见，但在大多数情况下是无症状的。重新开始是罕见的，并且不常规需要网格。老年人的大无症状HHS通常不需要干预。

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