4.4 Article

The Hill antireflux repair at 5 institutions over 25 years

Journal

AMERICAN JOURNAL OF SURGERY
Volume 201, Issue 5, Pages 597-602

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2011.02.002

Keywords

Antireflux surgery; Long-term; Hill repair; Fundoplication; Multi-institution; Nissen

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BACKGROUND: Long-term (> 5 years) studies of antireflux operations are needed. This study evaluates long-term results of the open Hill repair at multiple institutions. METHODS: This is a retrospective cohort study of open Hill repairs from 1972 to 1997 at 5 North American medical centers with a mean follow-up of 10 years. Objective data and standardized clinical outcomes were collected at a central site. Subjective results, medication use, and satisfaction scales were obtained through scripted phone interview. Results between 2 Hill-trained centers and 3 independent centers were compared. RESULTS: One thousand one hundred eighty-one patients met the inclusion criteria. Symptomatic improvement was found in 97% and good to excellent results in 93%. Medication use was markedly reduced. Hiatal hernia recurrence was found in 77 (6.9%); the reoperation rate was 1.9%. Differences in outcomes between Hill centers and independent centers were minor. CONCLUSIONS: Excellent results with the open Hill repair are durable beyond 10 years and are reproducible. Anatomic recurrence and reoperative rates are low. (C) 2011 Elsevier Inc. All rights reserved.

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