Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

Addo, Alex; Broda, Andrew; Zahiri, H. Reza; Brooks, Ian M.; Park, Adrian

doi:10.1007/s00464-019-07054-9

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…[23][24][25] Our rate of normalization of hemoglobin with surgical repair of the hiatal hernia is consistent with prior reports of at least 45 patients in the surgical literature. 15,16,18,26 The range of normalization ranges from 60% to 91% and the reasons for these differences are multifactorial and can be attributed various factors identified in the current study as well as others. These include subtle differences in patient populations such as the presence of symptomatic anemia versus occult blood loss, 18 the degree of inclusion of patient's refractory to medical therapy, 16,27 and the proportion of females who have higher normalization rates.…”

Section: Discussionmentioning

confidence: 77%

“…15 Importantly, the proportion of patients with Cameron's ulcerations affects response rates given that this group experienced higher normalization rates compared to those without. 18,26 Lastly, study methodologies differed between studies including the timing of measured post-operative hemoglobin levels, 18 unclear calculations and results reporting normalization, 26 and whether pre-operative therapies such as iron and anti-acid medications were stopped. 16 Nevertheless, these results differ from 2 smaller studies that concluded that medical therapy was similar to surgical repair.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Hemoglobin Levels in Patients with Hiatal Hernia and Anemia Demonstrates a Durable Resolution When Surgery Utilized

Laliberte

Brandabur²,

Chang

et al. 2021

Foregut: The Journal of the American Foregut Society

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Objective: To describe the patterns of care of patients presenting with anemia and a hiatal hernia and to document hemoglobin levels at each stage of care. Background data: Anemia may be associated with hiatal hernia. Current medical guidelines recommend iron supplements and proton pump inhibitors (PPIs) as initial steps, but not surgical repair is not routinely recommended despite evidence of cure. Methods: Retrospective review of patients with anemia and hiatal hernia who underwent surgical repair. Hemoglobin, PPI use, and symptoms were assessed at diagnosis, preoperatively, and postoperatively. Results: We identified 116 predominantly female patients with type 3 hernias with 52.6% (n = 61) having Cameron ulcers. At baseline, 24.1% (n = 28) were transfused, 52% (n = 60) started on iron supplements, 72% (n = 84) on PPIs, and 10% (n = 12) on H2-blockers. Referral to surgery occurred 454 days (IQR: 129-1332) after anemia diagnosis. The mean Hgb at diagnosis was 9.79 (range: 4.8-12.7) in females and 10.9 (range: 7.7-12.9) in males, increasing to 11.1 (range: 5.4-15) and 11.4 (range: 5.8-15.9) with medical management. After laparoscopic repair, it increased to 12.3 (range: 8.1-14.8) and 13.4 (range: 8.9-16.8) at short term follow up. This was sustained at 12.8 (range: 8.8-17.7) and 14.2 (8.1-17) long term. Medical management normalized Hgb in 36% (n = 40/111); whereas surgery normalized Hgb in 62% (n = 64/104) short term and 74% (n = 69/93) long term. Cameron’s ulcers were associated with normalization in 85% (38/45) but only 62% (n = 21/34) when not present. Conclusion: Anemia associated with a hiatal hernia improves with medication, but the addition of surgery normalizes Hgb, appears durable, allows cessation of medication, and improves quality of life.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Changes in Hemoglobin Levels in Patients with Hiatal Hernia and Anemia Demonstrates a Durable Resolution When Surgery Utilized

Laliberte

Brandabur²,

Chang

et al. 2021

Foregut: The Journal of the American Foregut Society

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“…In a study conducted by Cheverie et al (16), it was reported that hiatal hernia causes anemia, and anemia disappears at a rate of 50% after repair. Besides, Addo et al (17) reported that Cameron ulcer healed, anemia disappeared, and the quality of life improved after hiatal hernia repair in patients with secondary chronic anemia. We investigated the extent of complications caused by anemia after hiatal hernia surgery, but the presence of stomach ulcers or anemia that stomach ulcers may cause was not discussed.…”

Section: Discussionmentioning

confidence: 99%

Preoperatif Aneminin Hiatal Herni Cerrahisi ve Postoperatif Komplikasyonlara Etkisi

Tazeoğlu

Esmer

Arslan

et al. 2022

Düzce Tıp Fakültesi Dergisi

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Amaç: Anemi, cerrahi geçiren tüm hastalarda artmış mortalite ve morbidite ile ilişkilidir. Bu çalışmada, hiatal herni cerrahisi öncesi aneminin ne ölçüde postoperatif komplikasyonlara neden olduğunu ortaya koymak amaçlandı. Gereç ve Yöntemler: Kliniğimizde, 2015 ve 2019 yılları arasında hiatal herni nedeniyle ameliyat edilmiş olan hastalar geriye dönük olarak incelendi. Hastalar demografik, preoperatif laboratuvar değerleri, preoperatif Charlson komorbidite indeksi skoru, hiatal herni tipi, postoperatif yoğun bakım gereksinimi, postoperatif komplikasyon varlığı, Clavien-Dindo skoru, kan transfüzyon ihtiyacı ve hastanede kalış süresi açısından karşılaştırıldı. Bulgular: Hastaların 109’u kadın ve 83’ü erkek idi. Yaş ortalaması 50,1±9,1 yıl idi. Hastaların 54'ü (%28,2) anemik grupta ve 138'i (%71,8) ise anemik olmayan grupta idi. Cinsiyet dağılımı açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktu (p=0,663). Gruplar yaş dağılımı açısından karşılaştırıldığında, anemik grubun anemik olmayan gruba göre daha yaşlı olduğu ve bu farkın istatistiksel olarak da anlamlı olduğu saptandı (p<0,001). Postoperatif komplikasyon oranı açısından gruplar arasında anlamlı bir fark vardı ve anemik grupta daha sık olduğu görüldü (p<0,001). Postoperatif dönemde yoğun bakım ünitesi ve kan transfüzyonu ihtiyacı açısından da gruplar arasında anlamlı bir fark vardı (sırasıyla p=0,020, p<0,001). Sonuç: Preoperatif anemi, hiatal herni cerrahisinde postoperatif komplikasyonları arttırır. Bu nedenle, hiatal herni ameliyatı öncesi anemi varlığı araştırılmalı ve anemisi olan hastalar postoperatif dönemde yakın takip edilmelidir.

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“…Extraesophageal symptoms are less well studied, but substantial evidence exists that pulmonary function as well as anemia from Cameron’s ulceration are all improved after PEH repair. 18 -20…”

mentioning

confidence: 99%

Indications for Repair of Minimally Symptomatic Paraesophageal Hernia: A Surgical Perspective

Buckley

Hill

Furay

2022

Foregut: The Journal of the American Foregut Society

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Paraesophageal hernias (PEH) represent a minority of hiatal hernias and yet have the highest potential for catastrophic consequences for patients. Patients with paraesophageal hernias tend to be older with more comorbidities. The risk to benefit calculation in the treatment of patients with a minimally symptomatic PEH can complicated. Surgical repair and management of hiatal hernias has come a long way since the first repairs were undertaken. Surgical risk has become minimal, while gains in quality of life have increased. Decisions for surgery should be undertaken by well informed patients who have benefited from consultation with a gastroenterologist and foregut surgeon. For most patients suffering with a symptomatic PEH, the risk benefit calculation has swung firmly toward surgical repair when a multi-specialty approach is taken.

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Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

Cited by 13 publications

References 17 publications

Changes in Hemoglobin Levels in Patients with Hiatal Hernia and Anemia Demonstrates a Durable Resolution When Surgery Utilized

Changes in Hemoglobin Levels in Patients with Hiatal Hernia and Anemia Demonstrates a Durable Resolution When Surgery Utilized

Preoperatif Aneminin Hiatal Herni Cerrahisi ve Postoperatif Komplikasyonlara Etkisi

Indications for Repair of Minimally Symptomatic Paraesophageal Hernia: A Surgical Perspective

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