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- W2913872079 abstract "Introduction: The surgical approach and technique for paraesophageal hernia (PEH) repair is much debated. The effect of PEH repair on esophageal physiology is not clearly known. The aim of this study was to determine the changes in high resolution esophageal manometry (HREM) and pH testing after PEH repair. Methods: Retrospective analysis of all patients who underwent PEH repair at our institution between Jan 1, 2006 and Dec 31, 2013 by a single thoracic surgeon (TWR) was performed. All patients had pH testing and HREM before and 2 months after PEH repair. Paired analysis was performed to determine the changes in HREM and pH testing after fundoplication. Results: A total of 339 patients underwent PEH repair during the study period. Mean age was 59.6±13.3 years and 242 (71.4%) were female. Majority of patients had Nissen fundoplication (326, 96.2%) with Dor, Toupet and Belsey Mark IV in 9, 2 and 2 respectively. Over 274 had Colles gastroplasty performed during the PEH repair. Table 1 presents the changes in HREM after fundoplication. Basal lower esophageal sphincter (LES) pressure was noted to be lower after fundoplication (19.3±10.5 vs. 23.4±15.2, P<0.001). There was no significant difference in HREM diagnosis by Chicago 3.0 classification. Table 2 presents the changes in pH testing after fundoplication. There was an improvement in all pH parameters post PEH repair. Normalization of total acid exposure after fundoplication was noted in 96 (75%) of the 128 patients who had abnormal total acid exposure prior to fundoplication.Table: Table. Changes in HREM after fundoplicationTable: Table. Changes in pH testing after fundoplicationConclusion: In patients undergoing PEH repair with fundoplication, an increase in LES residual pressure but interestingly, a decrease in basal LES pressure was noted. Additionally, a significant improvement in esophageal acid exposure is noted after fundoplication." @default.
- W2913872079 created "2019-02-21" @default.
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- W2913872079 date "2017-10-01" @default.
- W2913872079 modified "2023-10-18" @default.
- W2913872079 title "Physiological Changes in Esophageal Function Testing After Paraesophageal Hernia Repair" @default.
- W2913872079 doi "https://doi.org/10.14309/00000434-201710001-00400" @default.
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