Experience of laparoscopic paraesophageal hernia repair at a single institution

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• 作者：Jihui Li ; M.D.^a ; Raul J. Rosenthal ; M.D. ; F.A.C.S. ; F.A.S.M.B.S.^a ; ^{rosentr@ccf.org} ; Mayank Roy ; M.D. ; M.R.C.S.^a ; Samuel Szomstein ; M.D. ; F.A.C.S.^a ; Mark Sesto ; M.D. ; F.A.C.S.^b
• 关键词：Paraesophageal hernia ; Hiatal hernia ; Hernia repair ; Hernia recurrence ; Laparoscopy ; Antireflux surgery
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：July, 2012
• 卷：204
• 期：1
• 页码：60-65
• 文件大小：173 K

摘要

Background

Paraesophageal hernia patients are often elderly with complicating medical comorbidities, making surgical management complex in formulating a management strategy.

Methods

Between January 2005 and July 2009, 93 patients underwent surgical treatment of paraesophageal hernia, including 8 recurrent cases after multiple repairs. Open transabdominal surgeries were performed in 14 (15%) patients, and combined thoracotomy was performed in 1 (1%). Laparoscopic surgeries were performed in 78 (84%) patients with 4 (5%) conversions. Artificial prosthetics were used in 27 (29%) patients. Fundoplication was performed in 82 (88%) patients. Gastropexy or feeding tube gastrostomy was performed in 10 (11%) patients.

Results

The average length of the surgery was 125 minutes (range, 51-304 min). The mean blood loss was 100 mL. The average length of stay was 4 days (range, 1-14 d). There were 2 mortalities (2%) and 4 re-operations, with a recurrence rate of 2%.

Conclusions

Laparoscopic paraesophageal hernia repair can be performed safely with acceptable results when following a standard approach.