Laparoscopic management of totally intra-thoracic stomach with chronic volvulus

Toydemir, Toygar

doi:10.3748/wjg.v19.i35.5848

Cited by 11 publications

(9 citation statements)

References 38 publications

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“…As a referral center for the surgical treatment of hiatal hernias [27, 28], after confronting with an ICT following laparoscopic anti-reflux surgery [2] (LARS), we conducted an in-depth analysis of the reported cases in peer-reviewed medical journals. The main aim of this review is to emphasize the importance of awareness for the prevention and better management of this extremely mortal, but avoidable complication.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Çalıkoğlu¹,

Özgen²,

Toydemir³

et al. 2019

Heliyon

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Iatrogenic cardiac tamponade (ICT) is a dreadful complication of peri-hiatal surgery and vast majority occur during a hernia repair. Strikingly, against all warnings, the incidents and related deaths seem to be increasing. The aim of this review is to provide insight on how to prevent and challenge ICT. PubMed search identified 30 distinct ICTs with 10 deaths (33.3%) due to peri-hiatal procedures. Twenty-nine operations were mechanical repairs and laparoscopic anti-reflux surgery was the primary cause (n:18). Graft fixation (n:23) and helical tacks (n:13) were the main offenders. Initial symptom was hypotension affecting 92%. Seven ICTs were only identified at autopsy. All treated patients except one underwent a drainage. Almost all ICTs were caused by injury to the diaphragmatic dome, anterior to hiatus. In conclusion, peri-hiatal surgery-related ICT is extremely fatal. ICT mainly occurs during the repair of a hernia, a benign condition and therefore must be prevented. Graft fixation, around the ante-hiatal diaphragmatic dome must be abandoned. If mesh-augmentation is absolutely necessary, meticulous stitching must be preferred instead of fixators. Persistent hypotension during or following a peri-hiatal operation is an alarming sign of ICT. Increased awareness is mandatory for prevention and survival.

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Section: Introductionmentioning

confidence: 99%

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Çalıkoğlu¹,

Özgen²,

Toydemir³

et al. 2019

Heliyon

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“…The use of inert material in this study, however, occurred selectively since it is a procedure with possible complications, and erosion of viscera is particularly concerning. 2 Zhang et al performed a systematic review and meta-analysis analyzing 11 studies (4 randomized, 9 non-randomized), comparing patients after surgical repair to reduce risk of recurrence and gastroesophageal reflux, employing mesh (n = 719) vs. suture (n = 755). They concluded that mesh repair of hiatus hernia compared to a suture repair alone, might be associated with less recurrences, and biological mesh improved quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence is not well defined in the literature because it is associated with gastric volvulus secondary to hiatal hernia. 2 The primary volvulus is described as those with flaccidity of stomach ligaments and secondary ones related to the presence of large hiatal hernias. 3 – 5 …”

Section: Introductionmentioning

confidence: 99%

Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus

Lopes

Chaim

Santos

et al. 2020

JSLS

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Background: Gastric volvulus is a rare condition, characterized by abnormal rotation of the stomach, causing obstruction with risk of ischemia, necrosis, and perforation. It is associated with high morbidity and mortality rates and, as it is life threatening, early diagnosis and treatment are crucial.Methods: Retrospective study of medical records of intrathoracic gastric volvulus patients treated by video-laparoscopy from January 2000 to December 2018, in a University Hospital.Results: Thirty patients (34 surgical procedures -4 reoperations), 9 (30%) male and 21 (70%) female. The mean age was 57.65 6 32.65 and the mean body mass index was 27.11 6 3.5 kg/m 2 . The most prevalent symptoms were epigastric pain and dysphagia. In 41.17% of the cases, the contrast X-ray confirmed the diagnosis. All 34 cases were intrathoracic volvulus, 24 of which were organo-axial (70.58%). The surgical technique used was hiatoplasty, without mesh (25 cases; 73.52%) and with reinforcement mesh (9 cases; 26.47%), mostly associated with Nissen fundoplication (52.94%). The mean surgical time was 215.7 6 62.9 minutes, with conversion in 5 cases (15.62%). Hospitalization ranged from 4 6 2 days. There was no record of operative mortality, and symptom improvement occurred in 100% of patients. The mean follow-up time for patients was 41.8 6 32.6 months.Conclusions: Surgical treatment should be indicated to reduce morbidity and mortality, and associated with improved symptoms and patient prognosis. Video-laparoscopic surgery on intrathoracic gastric volvulus proved to be safe and effective and should be the option of choice in the management of this disease.

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“…It can present with gastric outlet obstruction, ischaemia and/or perforation 1 2. Borchardt’s triad of epigastralgia, retching and inability to pass a nasogastric tube are classical symptoms.…”

Section: Descriptionmentioning

confidence: 99%

Laparoscopic repair of large paraoesophageal hernia with totally intrathoracic stomach

et al. 2014

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Laparoscopic management of totally intra-thoracic stomach with chronic volvulus

Abstract: The laparoscopic management of IGV is a safe but technically demanding procedure. The best outcomes can be achieved in centers with extensive experience in minimally invasive esophageal surgery.

Cited by 11 publications

References 38 publications

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus

Laparoscopic repair of large paraoesophageal hernia with totally intrathoracic stomach

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