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Review
. 2019 Nov;29(4):379-386.
doi: 10.1016/j.thorsurg.2019.07.003. Epub 2019 Sep 26.

Management of Paraesophageal Hernia in the Morbidly Obese Patient

Charles T Bakhos  1 , Shrey P Patel  2 , Roman V Petrov  3 , Abbas El-Sayed Abbas  3
Affiliations
Review

Management of Paraesophageal Hernia in the Morbidly Obese Patient

Charles T Bakhos et al. Thorac Surg Clin. 2019 Nov.

Abstract

Gastroesophageal reflux disease (GERD) is common in the morbidly obese population, and hiatal hernias are encountered in 20% to 52% of patients. Primary surgical repair of hiatal hernias, in particular the paraesophageal type, is associated with a higher recurrence rate in obese patients. Concomitant weight loss surgery may be advisable. Combined sleeve gastrectomy and paraesophageal hiatal hernia repair is feasible but can induce or worsen preexisting GERD. A Roux-en-Y gastric bypass offers advantages of more pronounced excess weight loss and better symptom control, albeit with a potentially higher rate of morbidity compared with paraesophageal hernia repair alone or sleeve gastrectomy.

Keywords: Bariatric surgery; Hiatal hernia; Lower esophageal sphincter; Reflux.

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