Efficacy and safety of recurrent paraesophageal hernia repair with Roux-en-Y gastric bypass

Matthew D. Spann, Noah J. Harrison, Wayne J. English, Aaron R. Bolduc, Chetan V. Aher, D. Brandon Williams, Alexander T. Hawkins

Research output: Contribution to journalArticle

Abstract

Roux-en-Y gastric bypass (RYGB) has been explored as a revisional option to failed paraesophageal hernia (PEH) repair with fundoplication, particularly in patients suffering from obesity. However, few studies have assessed long-term outcomes of RYGB with revisional PEH repair in regard to acid-suppressing medication use. We retrospectively identified 19 patients who underwent revisional PEH repair with RYGB between 2011 and 2018. The median operative time was 232 minutes with a median hospital length of stay of two days. The median length of follow-up was 24 months. Two patients (10.5%) had complications in the first 30 days, and five patients (26.3%) had complications within one year. Of the 12 patients on preoperative acid suppression, 6 (50%) were either off medication or on reduced dose at 12 months. The median BMI decrease was 14.4 kg/m2 at 12 months and did not change significantly afterward. Although rates of acid-suppression medication use did not change overall after revisional PEH repair with RYGB, patients experienced successful long-term management of morbid obesity and sustained weight loss. Revisional PEH repair with RYGB is a safe and effective option, with a complication rate comparable with the reported rates after revisional foregut procedures such as revisional Nissen fundoplication.

Original languageEnglish (US)
Pages (from-to)250-255
Number of pages6
JournalAmerican Surgeon
Volume86
Issue number3
StatePublished - 2020
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Spann, M. D., Harrison, N. J., English, W. J., Bolduc, A. R., Aher, C. V., Brandon Williams, D., & Hawkins, A. T. (2020). Efficacy and safety of recurrent paraesophageal hernia repair with Roux-en-Y gastric bypass. American Surgeon, 86(3), 250-255.