Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study
Background and study aims Concomitant hiatal hernia (HH) repair with transoral incisionless fundoplication (TIF) is a therapeutic option for patients with HH > 2 cm and gastroesophageal reflux disease (GERD). Data comparing this approach with laparoscopic Nissen fundoplication (LNF) are lacking....
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2023-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1972-9190 |
| _version_ | 1811173006094893056 |
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| author | Veeravich K. Jaruvongvanich Reem Matar Janani Reisenauer Peter Janu Peter Mavrelis Glenn Ihde Michael Murray Sneha Singh Jennifer Kolb Ninh T. Nguyen Nirav Thosani Erik B. Wilson Rasa Zarnegar Kenneth Chang Marcia I. Canto Barham K. Abu Dayyeh |
| author_facet | Veeravich K. Jaruvongvanich Reem Matar Janani Reisenauer Peter Janu Peter Mavrelis Glenn Ihde Michael Murray Sneha Singh Jennifer Kolb Ninh T. Nguyen Nirav Thosani Erik B. Wilson Rasa Zarnegar Kenneth Chang Marcia I. Canto Barham K. Abu Dayyeh |
| author_sort | Veeravich K. Jaruvongvanich |
| collection | DOAJ |
| description | Background and study aims Concomitant hiatal hernia (HH) repair with transoral incisionless fundoplication (TIF) is a therapeutic option for patients with HH > 2 cm and gastroesophageal reflux disease (GERD). Data comparing this approach with laparoscopic Nissen fundoplication (LNF) are lacking. We performed an exploratory analysis to compare these two approaches' adverse events (AEs) and clinical outcomes.
Patients and methods This was a multicenter retrospective cohort study of HH repair followed by LNF versus HH repair followed by TIF in patients with GERD and moderate HH (2–5 cm). AEs were assessed using the Clavien-Dindo classification. Symptoms (heartburn/regurgitation, bloating, and dysphagia) were compared at 6 and 12 months.
Results A total of 125 patients with HH repair with TIF and 70 with HH repair with LNF were compared. There was no difference in rates of discontinuing or decreasing proton pump inhibitor use, dysphagia, esophagitis, disrupted wrap, and HH recurrence between the two groups (P > 0.05). The length of hospital stay (1 day vs. 2 days), 30-day readmission rate (0 vs. 4.3 %), early AE rate (0 vs. 18.6 %), and early serious AE rate (0 vs. 4.3 %) favored TIF (all P < 0.05). The rate of new or worse than baseline bloating was lower in the TIF group at 6 months (13.8 % vs. 30.0 %, P = 0.009).
Conclusions Concomitant HH repair with TIF is feasible and associated with lower early and serious AEs compared to LNF. Further comparative efficacy studies are warranted. |
| first_indexed | 2024-04-10T17:40:50Z |
| format | Article |
| id | doaj.art-2fd8ed15876941968244ef9d1290f6c0 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-10T17:40:50Z |
| publishDate | 2023-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-2fd8ed15876941968244ef9d1290f6c02023-02-03T13:46:24ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362023-01-011101E11E1810.1055/a-1972-9190Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective studyVeeravich K. Jaruvongvanich0Reem Matar1Janani Reisenauer2Peter Janu3Peter Mavrelis4Glenn Ihde5Michael Murray6Sneha Singh7Jennifer Kolb8Ninh T. Nguyen9Nirav Thosani10Erik B. Wilson11Rasa Zarnegar12Kenneth Chang13Marcia I. Canto14Barham K. Abu Dayyeh15Mayo Clinic – Gastroenterology and Hepatology, Rochester, Minnesota, United StatesMayo Clinic – Gastroenterology and Hepatology, Rochester, Minnesota, United StatesMayo Clinic – Thoracic Surgery, Rochester, Minnesota, United StatesFox Valley Technical College, ThedaCare Regional Medical System, Appleton, Wisconsin, United StatesMethodist Hospitals Inc. – Surgery, Gary, Indiana, United StatesMatagorda Regional Medical Center – Matagorda Medical Group, Bay City, Texas, United StatesUNRMed – University of Nevada, Reno, Nevada, United StatesMayo Clinic – Gastroenterology and Hepatology, Rochester, Minnesota, United StatesUCIrvine – Gastroenterology, Irvine, California, United StatesUCIrvine – Surgery, Irvine, California, United StatesUniversity of Texas McGovern Medical School – Gastroenterology, Hepatology and Nutrition, Houston, Texas, United StatesUniversity of Texas McGovern Medical School – Surgery, Houston, Texas, United StatesWeill Cornell Medical College – Surgery, New York, New York, United StatesUCIrvine – Gastroenterology, Irvine, California, United StatesJohns Hopkins Hospital and Health System – Gastroenterology, Baltimore, Maryland, United StatesMayo Clinic – Gastroenterology and Hepatology, Rochester, Minnesota, United StatesBackground and study aims Concomitant hiatal hernia (HH) repair with transoral incisionless fundoplication (TIF) is a therapeutic option for patients with HH > 2 cm and gastroesophageal reflux disease (GERD). Data comparing this approach with laparoscopic Nissen fundoplication (LNF) are lacking. We performed an exploratory analysis to compare these two approaches' adverse events (AEs) and clinical outcomes. Patients and methods This was a multicenter retrospective cohort study of HH repair followed by LNF versus HH repair followed by TIF in patients with GERD and moderate HH (2–5 cm). AEs were assessed using the Clavien-Dindo classification. Symptoms (heartburn/regurgitation, bloating, and dysphagia) were compared at 6 and 12 months. Results A total of 125 patients with HH repair with TIF and 70 with HH repair with LNF were compared. There was no difference in rates of discontinuing or decreasing proton pump inhibitor use, dysphagia, esophagitis, disrupted wrap, and HH recurrence between the two groups (P > 0.05). The length of hospital stay (1 day vs. 2 days), 30-day readmission rate (0 vs. 4.3 %), early AE rate (0 vs. 18.6 %), and early serious AE rate (0 vs. 4.3 %) favored TIF (all P < 0.05). The rate of new or worse than baseline bloating was lower in the TIF group at 6 months (13.8 % vs. 30.0 %, P = 0.009). Conclusions Concomitant HH repair with TIF is feasible and associated with lower early and serious AEs compared to LNF. Further comparative efficacy studies are warranted.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1972-9190 |
| spellingShingle | Veeravich K. Jaruvongvanich Reem Matar Janani Reisenauer Peter Janu Peter Mavrelis Glenn Ihde Michael Murray Sneha Singh Jennifer Kolb Ninh T. Nguyen Nirav Thosani Erik B. Wilson Rasa Zarnegar Kenneth Chang Marcia I. Canto Barham K. Abu Dayyeh Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study Endoscopy International Open |
| title | Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study |
| title_full | Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study |
| title_fullStr | Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study |
| title_full_unstemmed | Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study |
| title_short | Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study |
| title_sort | hiatal hernia repair with transoral incisionless fundoplication versus nissen fundoplication for gastroesophageal reflux disease a retrospective study |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1972-9190 |
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