Concurrent large para-oesophageal hiatal hernia repair and laparoscopic Adjustable gastric banding

Results from 5-year follow up

Andrew J. Long, Paul R. Burton, Cheryl P. Laurie, Margaret Louise Anderson, Geoffrey S. Hebbard, Paul Edmond O'Brien, Wendy A. Brown

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Objective: The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias. 

Background: Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown. 

Methods: One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores. Results: At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9 % in the hernia repair group and 17.6 ± 12.6 % in the control group (p = 0.949), with 17 vs. 11 % loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5 %). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified. 

Conclusions: Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.

Original languageEnglish
Pages (from-to)1090-1096
Number of pages7
JournalObesity Surgery
Volume26
Issue number5
DOIs
Publication statusPublished - 1 May 2016

Keywords

  • Bariatric surgery
  • Laparoscopic adjustable gastric banding
  • Obesity
  • Para-oesophageal hiatal hernia
  • Reflux

Cite this

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title = "Concurrent large para-oesophageal hiatal hernia repair and laparoscopic Adjustable gastric banding: Results from 5-year follow up",
abstract = "Objective: The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias. Background: Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown. Methods: One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores. Results: At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9 {\%} in the hernia repair group and 17.6 ± 12.6 {\%} in the control group (p = 0.949), with 17 vs. 11 {\%} loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5 {\%}). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified. Conclusions: Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.",
keywords = "Bariatric surgery, Laparoscopic adjustable gastric banding, Obesity, Para-oesophageal hiatal hernia, Reflux",
author = "Long, {Andrew J.} and Burton, {Paul R.} and Laurie, {Cheryl P.} and Anderson, {Margaret Louise} and Hebbard, {Geoffrey S.} and O'Brien, {Paul Edmond} and Brown, {Wendy A.}",
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Concurrent large para-oesophageal hiatal hernia repair and laparoscopic Adjustable gastric banding : Results from 5-year follow up. / Long, Andrew J.; Burton, Paul R.; Laurie, Cheryl P.; Anderson, Margaret Louise; Hebbard, Geoffrey S.; O'Brien, Paul Edmond; Brown, Wendy A.

In: Obesity Surgery, Vol. 26, No. 5, 01.05.2016, p. 1090-1096.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Concurrent large para-oesophageal hiatal hernia repair and laparoscopic Adjustable gastric banding

T2 - Results from 5-year follow up

AU - Long, Andrew J.

AU - Burton, Paul R.

AU - Laurie, Cheryl P.

AU - Anderson, Margaret Louise

AU - Hebbard, Geoffrey S.

AU - O'Brien, Paul Edmond

AU - Brown, Wendy A.

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Y1 - 2016/5/1

N2 - Objective: The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias. Background: Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown. Methods: One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores. Results: At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9 % in the hernia repair group and 17.6 ± 12.6 % in the control group (p = 0.949), with 17 vs. 11 % loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5 %). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified. Conclusions: Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.

AB - Objective: The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias. Background: Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown. Methods: One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores. Results: At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9 % in the hernia repair group and 17.6 ± 12.6 % in the control group (p = 0.949), with 17 vs. 11 % loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5 %). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified. Conclusions: Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.

KW - Bariatric surgery

KW - Laparoscopic adjustable gastric banding

KW - Obesity

KW - Para-oesophageal hiatal hernia

KW - Reflux

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