PMID- 36618876 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230111 IS - 2364-3722 (Print) IS - 2196-9736 (Electronic) IS - 2196-9736 (Linking) VI - 11 IP - 1 DP - 2023 Jan TI - Hiatal hernia repair with transoral incisionless fundoplication versus Nissen fundoplication for gastroesophageal reflux disease: A retrospective study. PG - E11-E18 LID - 10.1055/a-1972-9190 [doi] AB - 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. CI - The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). FAU - Jaruvongvanich, Veeravich K AU - Jaruvongvanich VK AD - Mayo Clinic - Gastroenterology and Hepatology, Rochester, Minnesota, United States. FAU - Matar, Reem AU - Matar R AD - Mayo Clinic - Gastroenterology and Hepatology, Rochester, Minnesota, United States. FAU - Reisenauer, Janani AU - Reisenauer J AD - Mayo Clinic - Thoracic Surgery, Rochester, Minnesota, United States. FAU - Janu, Peter AU - Janu P AD - Fox Valley Technical College, ThedaCare Regional Medical System, Appleton, Wisconsin, United States. FAU - Mavrelis, Peter AU - Mavrelis P AD - Methodist Hospitals Inc. - Surgery, Gary, Indiana, United States. FAU - Ihde, Glenn AU - Ihde G AD - Matagorda Regional Medical Center - Matagorda Medical Group, Bay City, Texas, United States. FAU - Murray, Michael AU - Murray M AD - UNRMed - University of Nevada, Reno, Nevada, United States. FAU - Singh, Sneha AU - Singh S AD - Mayo Clinic - Gastroenterology and Hepatology, Rochester, Minnesota, United States. FAU - Kolb, Jennifer AU - Kolb J AD - UCIrvine - Gastroenterology, Irvine, California, United States. FAU - Nguyen, Ninh T AU - Nguyen NT AD - UCIrvine - Surgery, Irvine, California, United States. FAU - Thosani, Nirav AU - Thosani N AD - University of Texas McGovern Medical School - Gastroenterology, Hepatology and Nutrition, Houston, Texas, United States. FAU - Wilson, Erik B AU - Wilson EB AD - University of Texas McGovern Medical School - Surgery, Houston, Texas, United States. FAU - Zarnegar, Rasa AU - Zarnegar R AD - Weill Cornell Medical College - Surgery, New York, New York, United States. FAU - Chang, Kenneth AU - Chang K AD - UCIrvine - Gastroenterology, Irvine, California, United States. FAU - Canto, Marcia I AU - Canto MI AD - Johns Hopkins Hospital and Health System - Gastroenterology, Baltimore, Maryland, United States. FAU - Abu Dayyeh, Barham K AU - Abu Dayyeh BK AD - Mayo Clinic - Gastroenterology and Hepatology, Rochester, Minnesota, United States. LA - eng PT - Journal Article DEP - 20230104 PL - Germany TA - Endosc Int Open JT - Endoscopy international open JID - 101639919 PMC - PMC9812651 COIS- Competing interests Dr. Abu Dayyeh is a consultant for Metamodix, BFKW, DyaMx, Boston Scientific, USGI medical, Hemostasis, and Endo-TAGSS. He has received research support from Apollo Endosurgery, USGI, Spatz Medical, Boston Scientific, GI Dynamics, Cairn Diagnostics, Aspire Bariatrics, and Medtronic. He has served as a speaker for Johnson & Johnson, EndoGastric Solutions, and Olympus. Dr. Janu is a consultant for EndoGastric Solutions, Ethicon/J&J, and Olympus. Dr. Murray is a consultant for Boston Scientific Corp, Pentax America. He has received research support from Pentax America. He has served as a speaker for AbbVie. He is an advisory board member for Colubris Rx. He has received royalties from UpToDate. Dr. Chang is a consultant for and has received educational research grants from EndoGastric Solutions, is a consultant for and has received educational grants from Cook and Olympus. Dr. Canto has received research support from EndoGastric Solutions and Pentax Medical Corporation and has received royalties from UpToDate. EDAT- 2023/01/10 06:00 MHDA- 2023/01/10 06:01 PMCR- 2023/01/01 CRDT- 2023/01/09 03:39 PHST- 2022/03/24 00:00 [received] PHST- 2022/10/19 00:00 [accepted] PHST- 2023/01/09 03:39 [entrez] PHST- 2023/01/10 06:00 [pubmed] PHST- 2023/01/10 06:01 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.1055/a-1972-9190 [doi] PST - epublish SO - Endosc Int Open. 2023 Jan 4;11(1):E11-E18. doi: 10.1055/a-1972-9190. eCollection 2023 Jan.