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Concurrent Large Para-oesophageal Hiatal Hernia Repair and Laparoscopic Adjustable Gastric Banding: Results from 5-year Follow Up

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Abstract

Objective

The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias.

Background

Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown.

Methods

One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores.

Results

At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9 % in the hernia repair group and 17.6 ± 12.6 % in the control group (p = 0.949), with 17 vs. 11 % loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5 %). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified.

Conclusions

Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.

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Disclosure Statement

The Centre for Obesity Research and Education has received funding for research purposes from Allergan, Inc., the manufacturer of the LAP-BAND. The authors declare that they have no additional conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Centre for Obesity Research and Education, Monash University, Melbourne, 3004, Australia

    Andrew J. Long, Paul R. Burton, Cheryl P. Laurie, Margaret L. Anderson, Paul E. O’Brien & Wendy A. Brown

  2. Monash University, Department of Surgery, The Alfred Hospital, 99 Commercial Rd, Melbourne, 3004, Australia

    Paul R. Burton & Wendy A. Brown

  3. Melbourne University, Department of Gastroenterology, Royal Melbourne Hospital, 300 Grattan St, Parkville, 3050, Australia

    Geoff S. Hebbard

Authors
  1. Andrew J. Long
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  2. Paul R. Burton
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  3. Cheryl P. Laurie
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  4. Margaret L. Anderson
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  5. Geoff S. Hebbard
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  6. Paul E. O’Brien
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  7. Wendy A. Brown
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Correspondence to Andrew J. Long.

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Long, A.J., Burton, P.R., Laurie, C.P. et al. Concurrent Large Para-oesophageal Hiatal Hernia Repair and Laparoscopic Adjustable Gastric Banding: Results from 5-year Follow Up. OBES SURG 26, 1090–1096 (2016). https://doi.org/10.1007/s11695-015-1881-6

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  • DOI: https://doi.org/10.1007/s11695-015-1881-6

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