Management of Complications in Paraesophageal Hernia Repair

Imai, Taryne A.; Soukiasian, Harmik J.

doi:10.1016/j.thorsurg.2019.07.009

Cited by 12 publications

(8 citation statements)

References 45 publications

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“…Current literature shows complications between 3 and 45%, with a 30-day reoperation between 1.6 and 4.9% 12 . Our results correlate positively with the literature, with Clavien-Dindo score >3 complications happening in 18% (9/49) and 30-day reoperation rate of 8% (4/49).…”

Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on Perioperative Outcomes for Complex Hiatus Hernia by Videolaparoscopy

Luna

Peixoto

Carvalho³

et al. 2022

ABCD, arq. bras. cir. dig.

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BACKGROUND: The influence of body mass index on perioperative complications of hiatal hernia surgery is controversial in the surgical literature. AIMS: The aim of this study was to evaluate the influence of body mass index on perioperative complications and associated risk factors for its occurrence. METHODS: Two groups were compared on the basis of body mass index: group A with body mass index <32 kg/m2 and group B with body mass index ³32 kg/m2. A multivariate analysis was carried out to identify independent predictors for complications. Complications were classified based on the Clavien-Dindo score. RESULTS: A total of 49 patients were included in this study, with 30 in group A and 19 in group B. The groups were compared based on factors, such as age, Charlson Comorbidity Index, surgical techniques used, type and location of hiatal hernia, and length of stay. Findings showed that 70% of patients had complex hiatal hernia. In addition, 14 complications also occurred: 7 pleuropulmonary and 7 requiring reoperation. From the seven reoperated, there were three recurrences, two gastrointestinal fistulas, one diaphragmatic hernia, and one incisional hernia. Complications were similar in both the groups, with type IV hiatal hernia being the only independent predictor. CONCLUSIONS: Body mass index does not affect perioperative complications in anti-reflux surgery and type IV hiatal hernia is an independent predictor of its occurrence.

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Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on Perioperative Outcomes for Complex Hiatus Hernia by Videolaparoscopy

Luna

Peixoto

Carvalho³

et al. 2022

ABCD, arq. bras. cir. dig.

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“…The morbidity of paraesophageal hernia repair can be 3–45% of patients and it is important to properly select patients where improvement is expected ( 3 ). Additionally, it is vital to select patients in which the risk of surgery does not outweigh the potential benefits; pulmonary complications and congestive heart failure in a pre-operative setting is predictive of increased post-operative mortality risk ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pathological manifestations of paraesophageal hernias include the displacement of the gastroesophageal (GE) junction superior to the diaphragm (type I or sliding), herniation of the gastric fundus superior to the diaphragm with the GE junction remaining in place (type II), a combination of GE junction and fundus displacement (type III), and lastly the herniation of additional organs superior to the diaphragm (type IV) ( 2 ). Patient presentations vary, and include: remaining asymptomatic, gastroesophageal reflux disease (GERD), early satiety, pain after meals, Cameron's ulcers, iron-deficiency anemia, more rarely, gastric volvulus, and respiratory complications due to compression of the lungs ( 3 ). When symptomatic, surgical intervention may be indicated for paraesophageal hernias.…”

Section: Introductionmentioning

confidence: 99%

Impact of Paraesophageal Hernia Repair on Respiratory Function: A Systematic Review

et al. 2021

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Background and Objectives: Surgical repair of hiatal and paraesophageal hernia is widely accepted for the treatment of gastroesophageal reflux symptoms. The respiratory benefit of this surgery is less clear. The objective of this review is to quantify the benefit to pulmonary function and subjective dyspnea of paraesophageal hernia repair with the aim of refining the indications and contraindications for elective paraesophageal hernia repair.Methods: Articles were gathered from systematic searches of the Medline Complete Database via the Creighton University Health Sciences Library literature search services. Publications with both pre and postoperative pulmonary function data or both pre and postoperative subjective dyspnea data with regards to surgical paraesophageal hernia repair were included.Results: Six studies were included in this review. The majority of studies in this review show improvement in pulmonary function postoperatively with regards to FEV1, FVC, and VC when stratified by % intrathoracic stomach (ITS), particularly in groups >50% ITS. No significant change was seen in postoperative DLCO or FEV1/FVC.Conclusion: Paraesophageal hernia repair has shown to improve pulmonary function both objectively and subjectively. This review was limited by the paucity of literature on the subject as well as the lack of a standardized method for measurement of %ITS.

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“…In addition, intraoperative complications can arise converting the procedure into an urgent intervention, although only in rare cases (1.8%) 7 . Iatrogenic gastric perforations, when recognized early, can be corrected with a linear stapler, while esophageal perforations can be reinforced with a gastric wrap, or a fundoplication, or partial posterior fundoplication can also be applied.…”

Section: Discussionmentioning

confidence: 99%

Esofagoyeyunostomía de emergencia en hernia hiatal tipo IV: reporte de caso

Pérez-Rivera

Oviedo

González‐Orozco

et al. 2020

CIRU

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Reconstruction of the digestive tract is a surgical challenge; we propose a novel and successful alternative using a large vascularized pedicled jejunum anastomosed to the cervical esophagus in an emergency situation. A 65-year-old female patient in follow-up due to a gigantic type IV paraesophageal hernia, whom underwent surgical hernial defect correction, had friable gastric tissue and esophageal lesions that forced an urgent esophagojejunostomy. Immediate post-operative recovery had no incidents and during the outpatient follow-up no complications were reported. This case report represents a paradigm change in the impossibility of raising the vascularized pedicled jejunum to the neck in an emergency situation.

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Management of Complications in Paraesophageal Hernia Repair

Cited by 12 publications

References 45 publications

Impact of Body Mass Index on Perioperative Outcomes for Complex Hiatus Hernia by Videolaparoscopy

Impact of Body Mass Index on Perioperative Outcomes for Complex Hiatus Hernia by Videolaparoscopy

Impact of Paraesophageal Hernia Repair on Respiratory Function: A Systematic Review

Esofagoyeyunostomía de emergencia en hernia hiatal tipo IV: reporte de caso

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