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Paraoesophageal hiatal hernias: when to operate.
J R Coll Surg Edinb. 1992 Apr; 37(2):97-8.JR

Abstract

Between 1979 and 1988, 29 cases of paraoesophageal hernia presented to one surgeon (F.D.S.). There were 23 women and six men and the mean(s.e.m.) age was 66.3(4.1) years. All were symptomatic and 13 hernias (45%) were complicated by gastric volvulus, haemorrhage or perforation. Ten (34%) had evidence of gastro-oesophageal reflux, suggesting a sliding component in these cases. Operation, mostly transthoracic, consisted of hernial reduction, crural repair and, if indicated, an antireflux procedure. There were three deaths. Two occurred as a result of spontaneous, intrathoracic perforation of the hernia. The third followed dilatation of a benign stricture 2 months after surgery. The only major complication was a pulmonary embolus with full recovery. The mean(s.e.m.) follow-up time was 47.6(7.8) months and there were no recurrences. This series confirms that symptomatic paraoesophageal hernias warrant early repair because of the frequency and severity of associated complications. Although debate continues as to whether this policy should be extended to asymptomatic paraoesophageal hernias, we suggest that this should be so.

Authors+Show Affiliations

Department of Thoracic Surgery, City Hospital, Nottingham, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1377272

Citation

Harriss, D R., et al. "Paraoesophageal Hiatal Hernias: when to Operate." Journal of the Royal College of Surgeons of Edinburgh, vol. 37, no. 2, 1992, pp. 97-8.
Harriss DR, Graham TR, Galea M, et al. Paraoesophageal hiatal hernias: when to operate. J R Coll Surg Edinb. 1992;37(2):97-8.
Harriss, D. R., Graham, T. R., Galea, M., & Salama, F. D. (1992). Paraoesophageal hiatal hernias: when to operate. Journal of the Royal College of Surgeons of Edinburgh, 37(2), 97-8.
Harriss DR, et al. Paraoesophageal Hiatal Hernias: when to Operate. J R Coll Surg Edinb. 1992;37(2):97-8. PubMed PMID: 1377272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paraoesophageal hiatal hernias: when to operate. AU - Harriss,D R, AU - Graham,T R, AU - Galea,M, AU - Salama,F D, PY - 1992/4/1/pubmed PY - 1992/4/1/medline PY - 1992/4/1/entrez SP - 97 EP - 8 JF - Journal of the Royal College of Surgeons of Edinburgh JO - J R Coll Surg Edinb VL - 37 IS - 2 N2 - Between 1979 and 1988, 29 cases of paraoesophageal hernia presented to one surgeon (F.D.S.). There were 23 women and six men and the mean(s.e.m.) age was 66.3(4.1) years. All were symptomatic and 13 hernias (45%) were complicated by gastric volvulus, haemorrhage or perforation. Ten (34%) had evidence of gastro-oesophageal reflux, suggesting a sliding component in these cases. Operation, mostly transthoracic, consisted of hernial reduction, crural repair and, if indicated, an antireflux procedure. There were three deaths. Two occurred as a result of spontaneous, intrathoracic perforation of the hernia. The third followed dilatation of a benign stricture 2 months after surgery. The only major complication was a pulmonary embolus with full recovery. The mean(s.e.m.) follow-up time was 47.6(7.8) months and there were no recurrences. This series confirms that symptomatic paraoesophageal hernias warrant early repair because of the frequency and severity of associated complications. Although debate continues as to whether this policy should be extended to asymptomatic paraoesophageal hernias, we suggest that this should be so. SN - 0035-8835 UR - https://www.unboundmedicine.com/medline/citation/1377272/Paraoesophageal_hiatal_hernias:_when_to_operate_ L2 - https://medlineplus.gov/hiatalhernia.html DB - PRIME DP - Unbound Medicine ER -