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[Results of surgical treatment of complicated paraesophageal hernias].
Ann Chir. 1996; 50(4):318-24.AC

Abstract

From January 1979 to May 1995, 18 patients (4 men, 14 women) with a mean age of 75.4 +/- 12.5 yr underwent surgery for a complicated paraesophageal hiatus hernia. In 5 patients, the complication was the first sign of the diagnosis. Thirteen patients had a history of digestive, respiratory, or cardiac symptoms (mean duration of symptoms 74 mo.; range 2-240 mo.); 9 of them were aware that they had a hiatus hernia. Ten patients presented with acute obstruction (associated with a perforation in 1 case, jaundice in 1 case, and righy lower lobe pneumonia in 1 case). Hemorrhage occurred in 6 patients (hematemesis 4 cases, melena 2 cases). One patient had a perforation and another had an abscess of the lower right lobe. Surgery was performed via a transabdominal approach in all cases (5 times as an emergency, 12 times as a delayed emergency procedure, and once as an elective procedure). The procedure was delayed in 13 cases because of successful nasogastric decompression. All patients underwent reintegration of the stomach, diaphragmatic repair and gastropexy. An antireflux procedure was performed in 14 cases. Seven patients had an ancillary procedure (including one splenectomy following decapsulation). There were no postoperative deaths. Two patients who underwent emergency surgery developed a benign complication. The outcome of 17 patients is known; none of them developed a recurrence. One patient who did not undergo an antireflux procedure presented with gastroesophageal reflux; another experienced pain during eructation. In conclusion, nearly two-thirds of all patients who present with an acute complication can benefit from medical preparation before surgery, a strategy that improves results.

Authors+Show Affiliations

Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, Nice.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

8758521

Citation

Mouroux, J, et al. "[Results of Surgical Treatment of Complicated Paraesophageal Hernias]." Annales De Chirurgie, vol. 50, no. 4, 1996, pp. 318-24.
Mouroux J, Bereder JM, Chazal M, et al. [Results of surgical treatment of complicated paraesophageal hernias]. Ann Chir. 1996;50(4):318-24.
Mouroux, J., Bereder, J. M., Chazal, M., Bernard, J. L., Elkaïm, D., Benchimol, D., Bourgeon, A., & Richelme, H. (1996). [Results of surgical treatment of complicated paraesophageal hernias]. Annales De Chirurgie, 50(4), 318-24.
Mouroux J, et al. [Results of Surgical Treatment of Complicated Paraesophageal Hernias]. Ann Chir. 1996;50(4):318-24. PubMed PMID: 8758521.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Results of surgical treatment of complicated paraesophageal hernias]. AU - Mouroux,J, AU - Bereder,J M, AU - Chazal,M, AU - Bernard,J L, AU - Elkaïm,D, AU - Benchimol,D, AU - Bourgeon,A, AU - Richelme,H, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 318 EP - 24 JF - Annales de chirurgie JO - Ann Chir VL - 50 IS - 4 N2 - From January 1979 to May 1995, 18 patients (4 men, 14 women) with a mean age of 75.4 +/- 12.5 yr underwent surgery for a complicated paraesophageal hiatus hernia. In 5 patients, the complication was the first sign of the diagnosis. Thirteen patients had a history of digestive, respiratory, or cardiac symptoms (mean duration of symptoms 74 mo.; range 2-240 mo.); 9 of them were aware that they had a hiatus hernia. Ten patients presented with acute obstruction (associated with a perforation in 1 case, jaundice in 1 case, and righy lower lobe pneumonia in 1 case). Hemorrhage occurred in 6 patients (hematemesis 4 cases, melena 2 cases). One patient had a perforation and another had an abscess of the lower right lobe. Surgery was performed via a transabdominal approach in all cases (5 times as an emergency, 12 times as a delayed emergency procedure, and once as an elective procedure). The procedure was delayed in 13 cases because of successful nasogastric decompression. All patients underwent reintegration of the stomach, diaphragmatic repair and gastropexy. An antireflux procedure was performed in 14 cases. Seven patients had an ancillary procedure (including one splenectomy following decapsulation). There were no postoperative deaths. Two patients who underwent emergency surgery developed a benign complication. The outcome of 17 patients is known; none of them developed a recurrence. One patient who did not undergo an antireflux procedure presented with gastroesophageal reflux; another experienced pain during eructation. In conclusion, nearly two-thirds of all patients who present with an acute complication can benefit from medical preparation before surgery, a strategy that improves results. SN - 0003-3944 UR - https://www.unboundmedicine.com/medline/citation/8758521/[Results_of_surgical_treatment_of_complicated_paraesophageal_hernias]_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -