PMID- 33517764
OWN - NLM
STAT- MEDLINE
DCOM- 20220113
LR  - 20220113
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 88
IP  - 2
DP  - 2022 Feb
TI  - Comparative Analysis of Patients with Robotic Hiatal Hernia Repairs with and 
      without Collis Gastroplasty.
PG  - 248-253
LID - 10.1177/0003134821989051 [doi]
AB  - INTRODUCTION: After extensive mediastinal dissection fails to achieve adequate 
      intra-abdominal esophageal length, a Collis gastroplasty(CG) is recommended to 
      decrease axial tension and reduce hiatal hernia recurrence. However, concerns 
      exist about staple line leak, and long-term symptoms of heartburn and dysphagia 
      due to the acid-producing neoesophagus which lacks peristaltic activity. This 
      study aimed to assess long-term satisfaction and GERD-related quality of life 
      after robotic fundoplication with CG (wedge fundectomy technique) and to compare 
      outcomes to patients who underwent fundoplication without CG. Outcomes studied 
      included patient satisfaction, resumption of proton pump inhibitors (PPI), length 
      of surgery (LOS), hospital stay, and reintervention. METHODS: This was a 
      single-center retrospective analysis of patients from January 2017 through 
      December 2018 undergoing elective robotic hiatal hernia repair and 
      fundoplication. 61 patients were contacted for follow-up, of which 20 responded. 
      Of those 20 patients, 7 had a CG performed during surgery while 13 did not. There 
      was no significant difference in size and type of hiatal hernias in the 2 groups. 
      These patients agreed to give their feedback via a GERD health-related quality of 
      life (GERD HRQL) questionnaire. Their medical records were reviewed for LOS, 
      length of hospital stay (LOH), and reintervention needed. Statistical analysis 
      was performed using SPSS v 25. Satisfaction and need for PPIs were compared 
      between the treatment and control groups using the chi-square test of 
      independence. RESULTS: Statistical analysis showed that satisfaction with outcome 
      and PPI resumption was not significantly different between both groups (P > .05). 
      There was a significant difference in the average ranks between the 2 groups for 
      the question on postoperative dysphagia on the follow-up GERD HRQL questionnaire, 
      with the group with CG reporting no dysphagia. There were no significant 
      differences in the average ranks between the 2 groups for the remaining 15 
      questions (P > .05). The median LOS was longer in patients who had a CG compared 
      to patients who did not (250 vs. 148 min) (P = .01). The LOH stay was not 
      significantly different (P > .05) with a median length of stay of 2 days observed 
      in both groups. There were no leaks in the Collis group and no reoperations, 
      conversions, or blood transfusions needed in either group. CONCLUSION: Collis 
      gastroplasty is a safe option to utilize for short esophagus noted despite 
      extensive mediastinal mobilization and does not adversely affect the LOH stay, 
      need for reoperation, or patient long-term satisfaction.
FAU - Perrone, John A
AU  - Perrone JA
AD  - Department of Surgery, 6473St. Joseph's University Medical Center, NJ, USA.
FAU - Yee, Stephanie
AU  - Yee S
AD  - Department of Surgery, 6473St. Joseph's University Medical Center, NJ, USA.
FAU - Guerrero, Manrique
AU  - Guerrero M
AD  - Department of Surgery, 6473St. Joseph's University Medical Center, NJ, USA.
FAU - Wang, Antai
AU  - Wang A
AD  - Department of Surgery, 6473St. Joseph's University Medical Center, NJ, USA.
FAU - Hanley, Brian
AU  - Hanley B
AD  - St. George's University School of Medicine, University Center Grenada, Grenada, 
      West Indies.
FAU - Zuberi, Jamshed
AU  - Zuberi J
AD  - Department of Surgery, 6473St. Joseph's University Medical Center, NJ, USA.
FAU - Damani, Tanuja
AU  - Damani T
AD  - Department of Surgery, 12297New York University Langone Health, NY, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20210131
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Female
MH  - Fundoplication/*methods
MH  - Gastroesophageal Reflux/complications/drug therapy/*surgery
MH  - Gastroplasty/*methods/statistics & numerical data
MH  - Hernia, Hiatal/*surgery
MH  - Herniorrhaphy/*methods
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Patient Satisfaction/statistics & numerical data
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Quality of Life
MH  - Reoperation/statistics & numerical data
MH  - Retrospective Studies
MH  - Robotic Surgical Procedures
MH  - Secondary Prevention/methods
MH  - Surgical Stapling
EDAT- 2021/02/02 06:00
MHDA- 2022/01/14 06:00
CRDT- 2021/02/01 05:29
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2022/01/14 06:00 [medline]
PHST- 2021/02/01 05:29 [entrez]
AID - 10.1177/0003134821989051 [doi]
PST - ppublish
SO  - Am Surg. 2022 Feb;88(2):248-253. doi: 10.1177/0003134821989051. Epub 2021 Jan 31.