Outcomes after a decade of laparoscopic giant paraesophageal hernia repair

摘要: Objective Laparoscopic repair of giant paraesophageal hernia is a complex operation requiring significant laparoscopic expertise. Our objective was to compare our current approach and outcomes for with previous experience. Methods A retrospective review patients undergoing nonemergency hernia, stratified by early versus era (January 1997–June 2003 July 2003–June 2008), performed. We evaluated clinical outcomes, barium esophagogram, quality life. Results performed in 662 (median age 70 years, range 19–92 years) median percentage herniated stomach 70% (range 30%–100%). With time, use Collis gastroplasty decreased (86% 53%), as did crural mesh reinforcement (17% 12%). Current were 50% more likely have Charlson comorbidity index score greater than 3. Thirty-day mortality 1.7% (11/662). Mortality complication rates stable despite increasing comorbid disease era. Postoperative gastroesophageal reflux health-related life scores available 489 (30-month follow-up), good excellent results 90% (438/489). Radiographic recurrence (15.7%) not associated symptom recurrence. Reoperation occurred 3.2% (21/662). Conclusions we obtained minimally invasive experience refined hernia. Perioperative morbidity remain low, increased the provided patient satisfaction improvement, even small radiographic recurrences. comparable best open series.