Page 32 - Read Online

Ugliono et al. Mini-invasive Surg 2021;5:2 I http://dx.doi.org/10.20517/2574-1225.2020.93 Page 9 of 12

To date, there is no consensus on the type of wrap and on the fixation of the fundoplication to the
[28]
esophagus or the diaphragmatic pillars . In a systematic review of the literature, including 24 studies,
[77]
Andolfi et al. concluded that the preferred approach should be a total fundoplication when the
esophageal motility is normal.

CONCLUSION
The current review of the literature shows that the controversies regarding the optimal repair of
paraesophageal hernia, including the best technique for crural closure, the addition of a fundoplication,
and of esophageal lengthening procedures, remain unresolved. The wide heterogeneity of techniques and
materials, together with the low incidence of PEH, makes it difficult to investigate the specific role of the
single technical factors concurring in PEH repair.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Ugliono E, Rebecchi F
Performed data acquisition, as well as provided administrative, technical, and material support: Seno E,
Morino M

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

REFERENCES
1. Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol
2008;22:601-16.
2. Hashemi M, Sillin LF, Peters JH. Current concepts in the management of paraesophageal hiatal hernia. J Clin Gastroenterol 1999;29:8-13.
3. Sihvo EI, Salo JA, Räsänen JV, Rantanen TK. Fatal complications of adult paraesophageal hernia: a population-based study. J Thorac
Cardiovasc Surg 2009;137:419-24.
4. Mitiek MO, Andrade RS. Giant hiatal hernia. Ann Thorac Surg 2010;89:S2168-73.
5. Kohn GP, Price RR, DeMeester SR, et al; SAGES Guidelines Committee. Guidelines for the management of hiatal hernia. Surg Endosc
2013;27:4409-28.
6. Skinner DB, Belsey RH. Surgical management of esophageal reflux and hiatus hernia. Long-term results with 1,030 patients. J Thorac
Cardiovasc Surg 1967;53:33-54.
7. Hill LD. Incarcerated paraesophageal hernia. Am J Surg 1973;126:286-91.
8. Stylopoulos N, Gazelle GS, Rattner DW. Paraesophageal hernias: operation or observation? Ann Surg 2002;236:492-500; discussion 500-1.