Maher El Chaar, Allincia Michaud, Scott Allen Farabaugh, Dustin Manchester, Meredith Harrison, Luis Alvarado
{"title":"机器人辅助裂孔疝修复有和没有磁性括约肌增强术(MSA):在一个学术中心的短期和长期以患者为中心的结果。","authors":"Maher El Chaar, Allincia Michaud, Scott Allen Farabaugh, Dustin Manchester, Meredith Harrison, Luis Alvarado","doi":"10.1007/s00464-025-11583-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Hiatal Hernia (HH) repairs are commonly performed using a laparoscopic (L) approach. Recently, the robotic-assisted (RA) approach was introduced. The objective of the study is to describe our experience and analyze patient-centered clinical outcomes of RA-HH repairs with and without MSA (Magnetic Sphincter Augmentation).</p><p><strong>Methods: </strong>Patients who underwent RA-HH repair with or without MSA between April 2018 and February 2023 were included. The data were summarized using mean and standard deviation for all continuous variables. Frequency and percent were used for categorical data. Postoperative endoscopy and/or barium swallow were done on all patients. Postoperative clinical follow-up occurred at 2 weeks, 3,6,12, and 24 months. At 6 months, the Gastroesophageal Reflux Disease Health-Related Quality-of-Life (GERD-HRQL) scale was used to assess quality of life and symptom severity. The data were analyzed for both MSA and non-MSA patients and reported at 2 years. All data management and analysis were conducted using Stata V.18.</p><p><strong>Results: </strong>Overall, the study included 295 patients. 30-day readmission and ED visit rates were 7.51% and 14.92%, respectively. In-hospital postoperative complication rate was 10.85%. We had no 30-day mortality. Conversion to open was 0.34%. Hospital length of stay was 0-1 day in 82.03% of cases. GERD-HRQL score decreased from 8.78 preoperatively to 1.34 at 6 months with 86.1% of patients reporting a score of 0. Our follow-up rate at year 2 from the index procedure was 74% ( 217 patients out of 295). Hernia recurrence rate at 24 months was 3.93%. PPI use at 2 years was 38.71%. MSA group had more post-op globus at 24 months (5.13% vs 1.12%) but similar rates of post-op heartburn and PPI use.</p><p><strong>Conclusion: </strong>RA-HH at our center appears to be safe and feasible with low recurrence rates at 24 months. MSA had similar rates of PPI use but more post-op globus compared to the non-MSA group at 2 years.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"2211-2220"},"PeriodicalIF":2.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Robotic-assisted hiatal hernia repairs with and without magnetic sphincter augmentation (MSA): short- and long-term patient-centered outcomes in a single academic center.\",\"authors\":\"Maher El Chaar, Allincia Michaud, Scott Allen Farabaugh, Dustin Manchester, Meredith Harrison, Luis Alvarado\",\"doi\":\"10.1007/s00464-025-11583-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Hiatal Hernia (HH) repairs are commonly performed using a laparoscopic (L) approach. Recently, the robotic-assisted (RA) approach was introduced. The objective of the study is to describe our experience and analyze patient-centered clinical outcomes of RA-HH repairs with and without MSA (Magnetic Sphincter Augmentation).</p><p><strong>Methods: </strong>Patients who underwent RA-HH repair with or without MSA between April 2018 and February 2023 were included. The data were summarized using mean and standard deviation for all continuous variables. Frequency and percent were used for categorical data. Postoperative endoscopy and/or barium swallow were done on all patients. Postoperative clinical follow-up occurred at 2 weeks, 3,6,12, and 24 months. At 6 months, the Gastroesophageal Reflux Disease Health-Related Quality-of-Life (GERD-HRQL) scale was used to assess quality of life and symptom severity. The data were analyzed for both MSA and non-MSA patients and reported at 2 years. All data management and analysis were conducted using Stata V.18.</p><p><strong>Results: </strong>Overall, the study included 295 patients. 30-day readmission and ED visit rates were 7.51% and 14.92%, respectively. In-hospital postoperative complication rate was 10.85%. We had no 30-day mortality. Conversion to open was 0.34%. Hospital length of stay was 0-1 day in 82.03% of cases. GERD-HRQL score decreased from 8.78 preoperatively to 1.34 at 6 months with 86.1% of patients reporting a score of 0. Our follow-up rate at year 2 from the index procedure was 74% ( 217 patients out of 295). Hernia recurrence rate at 24 months was 3.93%. PPI use at 2 years was 38.71%. MSA group had more post-op globus at 24 months (5.13% vs 1.12%) but similar rates of post-op heartburn and PPI use.</p><p><strong>Conclusion: </strong>RA-HH at our center appears to be safe and feasible with low recurrence rates at 24 months. 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引用次数: 0
摘要
简介:裂孔疝(HH)修补通常使用腹腔镜(L)方法进行。最近,机器人辅助(RA)方法被引入。本研究的目的是描述我们的经验,并分析以患者为中心的RA-HH修复有和没有MSA(磁性括约肌增强)的临床结果。方法:纳入2018年4月至2023年2月期间接受RA-HH修复且伴有或不伴有MSA的患者。使用所有连续变量的平均值和标准差对数据进行汇总。频率和百分比用于分类数据。所有患者术后均行内镜检查和/或钡餐。术后2周、3、6、12、24个月进行临床随访。6个月时,使用胃食管反流病健康相关生活质量(GERD-HRQL)量表评估生活质量和症状严重程度。对MSA和非MSA患者的数据进行分析,并在2年后报告。所有数据管理和分析均使用Stata V.18进行。结果:总体而言,该研究包括295名患者。30天再入院率和急诊率分别为7.51%和14.92%。术后住院并发症发生率为10.85%。我们没有30天死亡率。开户率为0.34%。住院时间0 ~ 1天的占82.03%。GERD-HRQL评分从术前的8.78下降到6个月时的1.34,86.1%的患者报告得分为0。第2年的随访率为74%(295例患者中有217例)。术后24个月疝复发率3.93%。2年PPI使用率为38.71%。MSA组在术后24个月有更多的球状物(5.13% vs 1.12%),但术后胃灼热和PPI使用率相似。结论:RA-HH治疗24个月复发率低,安全可行。2年时,与非MSA组相比,MSA组的PPI使用率相似,但术后球体更多。
Robotic-assisted hiatal hernia repairs with and without magnetic sphincter augmentation (MSA): short- and long-term patient-centered outcomes in a single academic center.
Introduction: Hiatal Hernia (HH) repairs are commonly performed using a laparoscopic (L) approach. Recently, the robotic-assisted (RA) approach was introduced. The objective of the study is to describe our experience and analyze patient-centered clinical outcomes of RA-HH repairs with and without MSA (Magnetic Sphincter Augmentation).
Methods: Patients who underwent RA-HH repair with or without MSA between April 2018 and February 2023 were included. The data were summarized using mean and standard deviation for all continuous variables. Frequency and percent were used for categorical data. Postoperative endoscopy and/or barium swallow were done on all patients. Postoperative clinical follow-up occurred at 2 weeks, 3,6,12, and 24 months. At 6 months, the Gastroesophageal Reflux Disease Health-Related Quality-of-Life (GERD-HRQL) scale was used to assess quality of life and symptom severity. The data were analyzed for both MSA and non-MSA patients and reported at 2 years. All data management and analysis were conducted using Stata V.18.
Results: Overall, the study included 295 patients. 30-day readmission and ED visit rates were 7.51% and 14.92%, respectively. In-hospital postoperative complication rate was 10.85%. We had no 30-day mortality. Conversion to open was 0.34%. Hospital length of stay was 0-1 day in 82.03% of cases. GERD-HRQL score decreased from 8.78 preoperatively to 1.34 at 6 months with 86.1% of patients reporting a score of 0. Our follow-up rate at year 2 from the index procedure was 74% ( 217 patients out of 295). Hernia recurrence rate at 24 months was 3.93%. PPI use at 2 years was 38.71%. MSA group had more post-op globus at 24 months (5.13% vs 1.12%) but similar rates of post-op heartburn and PPI use.
Conclusion: RA-HH at our center appears to be safe and feasible with low recurrence rates at 24 months. MSA had similar rates of PPI use but more post-op globus compared to the non-MSA group at 2 years.
期刊介绍:
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery