Laparoscopic surgery into mixed hiatal hernia. Results pre-operative and post-operative

• Published in: Revista española de enfermedades digestivas Vol. 101; no. 9; pp. 623 - 630
• Main Authors: Pagán Pomar, A, Palma Zamora, E, Ochogavia Segui, A, Llabres Rosello, M
• Format: Journal Article
• Language: English; Spanish; Portuguese
• Published: Spain Sociedad Española de Patología Digestiva 01.09.2009
• Subjects: Adult; Aged; Female; Fundoplication - methods; Gastroenterology & Hepatology; Geriatrics & Gerontology; Hernia, Diaphragmatic - surgery; Hernia, Hiatal - surgery; Humans; Infectious Diseases; Laparoscopy; Length of Stay; Male; Middle Aged; Oncology; Pathology; Pharmacology & Pharmacy; Radiology, Nuclear Medicine & Medical Imaging; Recurrence; Reoperation; Surgery; Surgical Mesh; Sutures; Time Factors; Treatment Outcome; Hernia hiatal; Hiatal hernia; Paraesophageal hernia; Laparoscopic antirreflux surgery; Hernia paraesofágica; Hernia diafragmática; Diaphragma hernia; Fundoplicatura laparoscópica; Prosthetic hiatal closure; Reparación con malla
• ISSN: 1130-0108; 1130-0108
• DOI: 10.4321/S1130-01082009000900005

The complications of the mixed hernia need, often, surgical treatment. In the asymtomatic patients this one treatment is controversial, due to her complex repair and the high percentage of relapse informed in the long term. The surgical classic routes, they present raised morbi-mortality related to the extent of the incisions, to long hospitable stays and slow recovery. Between October, 2001 to November, 2007 we check 39 patients with hernia hiatal mixed with a middle ages of 65 years (35-78 years). In Lloyd-Davies s position, the content diminishes hernia and the redundant sack is resected. The diaphragmatic props are sutured by material not reabsorbable. Mesh of reinforcement intervened in 7/39 repairs. It concludes with a partial or complete antirreflux depending on the report. The operative average time was of 126 min; the hospital stay of 2.46 days. The complications perioperatives are principally cardiorespiratory. A patient died for an intestinal inadvertent perforation during the intervention and of late diagnosis. We realize traffic gastroduodenal to 12 months in 28 patients (71.7%). We find relapse in 8 patients (20.5%). Four asymtomatic patients, with chance find in the radiological control. Three patients with pirosis that needs treatment and one of the relapses needed reintervention for strangulation of a gastric volvulus. The laparoscopic surgery offers safety and efficiency with rapid postoperatory recovery, minor morbidity and hospitable stay. After the surgery, the long-term relapse presents similar results to the opened surgery, though the interposition of mesh can propitiate her decrease.