Early Routine Use of Upper GI Contrast Series Post Paraesophageal Hernia Repair: A Single Institution Consecutive Case Series

Surg Laparosc Endosc Percutan Tech. 2019 Jun;29(3):203-206. doi: 10.1097/SLE.0000000000000643.

Abstract

Introduction: There is conflicting evidence with regard to the routine use of upper gastrointestinal contrast series in detecting early complications post paraesophageal hernia repair (PEHR).

Methods: All cases booked for a PEHR between January 2007 and September 2015 were identified using hospital records. Standard demographic, operation, and imaging data were extracted.

Results: We retrospectively identified 391 PEHR cases between January 2007 and September 2015. The mean age at the index operation was 66.7 years with a female predominance. The majority of index operations were elective and completed for a large paraesophageal hernia. Contrast studies were reported as normal in 70.6%, a leak in 0.3%, an obstruction in 27.9%, and early recurrence in 1.0%. Reoperation was required in 1.8% of cases.

Conclusion: Routine upper gastrointestinal contrast studies post-PEHR changed management in 0.8% of cases and were unhelpful in determining the need for early reoperation in 57.1% of cases requiring reoperation.

MeSH terms

  • Aged
  • Contrast Media*
  • Elective Surgical Procedures
  • Female
  • Fundoplication / methods
  • Gastrointestinal Tract / diagnostic imaging
  • Hernia, Hiatal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Male
  • Postoperative Care / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Recurrence
  • Reoperation / statistics & numerical data
  • Retrospective Studies

Substances

  • Contrast Media