PMID- 32805579
OWN - NLM
STAT- MEDLINE
DCOM- 20210310
LR  - 20210310
IS  - 1095-8673 (Electronic)
IS  - 0022-4804 (Linking)
VI  - 256
DP  - 2020 Dec
TI  - Proton Pump Inhibitor Use After Hiatal Hernia Repair: Inhibitor of Recurrent 
      Symptoms and Potential Revisional Surgery.
PG  - 570-576
LID - S0022-4804(20)30490-X [pii]
LID - 10.1016/j.jss.2020.07.033 [doi]
AB  - BACKGROUND: Hiatal hernia recurrence after hiatal hernia repair (HHR) is often 
      underdiagnosed and underreported but may present with recurrent gastroesophageal 
      reflux disease (GERD) symptoms. Because of their availability, proton pump 
      inhibitor (PPI) use is common and may mask patients who would benefit from 
      revisional surgery, which has been shown to improve symptoms and quality of life. 
      METHODS: A retrospective analysis was performed to evaluate recurrence patterns 
      of patients who underwent HHR, specifically for the indication of GERD, from 2007 
      to 2015 at a single Veterans Administration Medical Center. Clinicopathologic 
      parameters were reviewed for association with hiatal hernia recurrence, including 
      postoperative PPI use. RESULTS: Sixty-four patients were identified with a median 
      follow-up time of 57.8 mo. Thirty-eight patients developed an anatomic 
      recurrence, which did not demonstrate any associated factors on univariate 
      analysis. Seventy percent of patients remained or were restarted on PPI after 
      their initial surgery. For patients with a documented recurrence, the median time 
      to start a PPI was 224 d, but the time to identify recurrence on imaging or 
      endoscopy was 712.5 d. Eleven (39.3%) patients had a reintervention for anatomic 
      recurrence, of which all had developed recurrent symptoms of GERD. CONCLUSIONS: 
      Most patients who developed recurrent hiatal hernia were restarted on PPI without 
      workup for their symptoms. The time of initiation of PPI was much earlier than 
      the time of identification of a recurrent hiatal hernia. The use of PPIs in 
      patients whom have undergone HHR may delay proper workup to identify recurrent 
      hiatal hernia amenable to surgical repair and should be reserved until patients 
      develop recurrent symptoms and have at least begun a diagnostic workup to rule 
      out an anatomic cause for the recurrent symptoms.
CI  - Published by Elsevier Inc.
FAU - Oppenheimer, Eittel E
AU  - Oppenheimer EE
AD  - Department of Surgery, North Florida/South Georgia Veterans Health System, 
      Gainesville, Florida.
FAU - Schmit, Bradley
AU  - Schmit B
AD  - Department of Surgery, North Florida/South Georgia Veterans Health System, 
      Gainesville, Florida.
FAU - Sarosi, George A Jr
AU  - Sarosi GA Jr
AD  - Department of Surgery, North Florida/South Georgia Veterans Health System, 
      Gainesville, Florida; Department of Surgery, University of Florida College of 
      Medicine, Gainesville, Florida.
FAU - Thomas, Ryan M
AU  - Thomas RM
AD  - Department of Surgery, North Florida/South Georgia Veterans Health System, 
      Gainesville, Florida; Department of Surgery, University of Florida College of 
      Medicine, Gainesville, Florida. Electronic address: Ryan.Thomas@surgery.ufl.edu.
LA  - eng
PT  - Journal Article
DEP - 20200814
PL  - United States
TA  - J Surg Res
JT  - The Journal of surgical research
JID - 0376340
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Delayed Diagnosis/prevention & control
MH  - Female
MH  - Follow-Up Studies
MH  - Gastroesophageal Reflux/*diagnosis/drug therapy/etiology
MH  - Hernia, Hiatal/complications/diagnosis/*surgery
MH  - *Herniorrhaphy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care/adverse effects/*standards/statistics & numerical data
MH  - Practice Guidelines as Topic
MH  - Proton Pump Inhibitors/administration & dosage/adverse effects/*standards
MH  - Quality of Life
MH  - Recurrence
MH  - Reoperation/statistics & numerical data
MH  - Retrospective Studies
MH  - Time-to-Treatment/standards/statistics & numerical data
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Antireflux surgery
OT  - Gastroesophageal reflux disease
OT  - Hiatal hernia
OT  - Proton pump inhibitors
EDAT- 2020/08/18 06:00
MHDA- 2021/03/11 06:00
CRDT- 2020/08/18 06:00
PHST- 2020/02/28 00:00 [received]
PHST- 2020/06/22 00:00 [revised]
PHST- 2020/07/11 00:00 [accepted]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/03/11 06:00 [medline]
PHST- 2020/08/18 06:00 [entrez]
AID - S0022-4804(20)30490-X [pii]
AID - 10.1016/j.jss.2020.07.033 [doi]
PST - ppublish
SO  - J Surg Res. 2020 Dec;256:570-576. doi: 10.1016/j.jss.2020.07.033. Epub 2020 Aug 
      14.