Imperial College London
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DrPiersBoshier

Faculty of Medicine, Department of Surgery & Cancer

Clinical Research Fellow
 
 
 
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Contact

 

piers.boshier03 CV

 
 
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Location

 

1035Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wirsching:2019:dote/doz032,
author = {Wirsching, A and Klevebro, F and Boshier, PR and Hubka, M and Kuppusamy, MK and Kirtland, SH and Low, DE},
doi = {dote/doz032},
journal = {Diseases of the Esophagus},
title = {The other explanation for dyspnea: giant paraesophageal hiatal hernia repair routinely improves pulmonary function},
url = {http://dx.doi.org/10.1093/dote/doz032},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Paraesophageal hiatal hernias (PEHs) are most commonly associated with gastrointestinal symptoms; less widely appreciated is their potentially important influence on respiratory function. We hypothesize that surgical repair of PEH will significantly improve not only gastrointestinal symptoms, but also preoperative dyspnea and spirometry scores. A prospective Institutional Review Board-approved database was used to review all patients undergoing PEH repair from 2000 to 2016. Patients with pre- and postoperative pulmonary function tests assessed by spirometry were included. Postoperative changes in spirometry measurements were compared to PEH size as reflected by the percentage of intrathoracic stomach observed on preoperative contrast studies. Patients were stratified according to improvement in forced expiratory volume in 1 second (FEV1). Patients with >12% ('significant') improvement in FEV1 after surgery were compared to the remaining patient population. In total, 299 patients met the inclusion criteria. Symptomatic improvement in respiratory function was noted in all patients after PEH repair. Age, gender, BMI, presenting symptoms, Charlson comorbidity index as well as preoperative comorbidities did not significantly impact the functional outcome. Spirometry results improved in 80% of the patients, 21% of whom showed an improvement of >20% compared to the preoperative level. 'Significant' improvement in respiratory function was seen in 122 of 299 (41%) patients. Patients presenting with moderate and severe preoperative pulmonary obstruction demonstrated 'significant' improvement in FEV1 in 48% and 40% of cases, respectively. Large PEHs, characterized by a percentage of intrathoracic stomach >75%, was strongly associated with 'significant' improvement in FEV1 (P = 0.001). PEHs can impact subjective and objective respiratory status and surgical repair can result in a significant improvement in dyspnea and pulmonary function score t
AU  - Wirsching,A
AU  - Klevebro,F
AU  - Boshier,PR
AU  - Hubka,M
AU  - Kuppusamy,MK
AU  - Kirtland,SH
AU  - Low,DE
DO  - dote/doz032
PY  - 2019///
SN  - 1120-8694
TI  - The other explanation for dyspnea: giant paraesophageal hiatal hernia repair routinely improves pulmonary function
T2  - Diseases of the Esophagus
UR  - http://dx.doi.org/10.1093/dote/doz032
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31220858
ER  -
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