JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2007
Intermediate-term results of laparoscopic repair of giant paraesophageal hernia: lack of follow-up esophagogram leads to detection bias.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rathore Munir A, Andrabi Imran, Nambi El, McMurray Arthur H
Аннотация
INTRODUCTION: This retrospective study was performed to review the intermediate-term results of the laparoscopic repair of giant paraesophageal hernia (PEH) in the unit.
METHODS: This retrospective 8-year case series involved 42 patients. The clinical records were retrieved, reviewed individually, and data were collected regarding symptoms, investigation, operative details, and follow-up.
RESULTS: M:F ratio was 1:1.8 and median age was 64 years. Symptoms included epigastric/chest pain (69%), heartburn (42.8%), dysphagia (38%), vomiting (23.8%), gastric volvulus (19%), and upper GI bleed (16.6%). The repair included reduction, sac excision, esophageal mobilization, and cruroplasty. Fundoplication (anterior partial) was done in 18 (42.8%) patients with radiologically documented reflux. Median hospital stay was 3 days. The complications included esophageal perforation in 1 (2.3%), gas-forming mediastinal abscess in 1 (2.3%), small bowel obstruction in 1 (2.3%), and bilateral basal atelectasis in 3 (7.1%). One patient (2.3%) died due to duodenal perforation and myocardial infarction. Of the 38 (90.4%) patients followed up (median 18m), 20 (52.6%) had a follow-up investigation. One patient (2.6%) had postoperative dysphagia, and 3 (7.8%) had postoperative heartburn. Five (11.9%) had recurrence. Symptom outcome was Visick grades I/II (86.8%), III (10.5%), and IV (2.6%).
CONCLUSION: Laparoscopic repair of PEH resulted in a short length of stay, excellent outcome in almost 87% of patients, and an overall recurrence rate of 11.9%.
METHODS: This retrospective 8-year case series involved 42 patients. The clinical records were retrieved, reviewed individually, and data were collected regarding symptoms, investigation, operative details, and follow-up.
RESULTS: M:F ratio was 1:1.8 and median age was 64 years. Symptoms included epigastric/chest pain (69%), heartburn (42.8%), dysphagia (38%), vomiting (23.8%), gastric volvulus (19%), and upper GI bleed (16.6%). The repair included reduction, sac excision, esophageal mobilization, and cruroplasty. Fundoplication (anterior partial) was done in 18 (42.8%) patients with radiologically documented reflux. Median hospital stay was 3 days. The complications included esophageal perforation in 1 (2.3%), gas-forming mediastinal abscess in 1 (2.3%), small bowel obstruction in 1 (2.3%), and bilateral basal atelectasis in 3 (7.1%). One patient (2.3%) died due to duodenal perforation and myocardial infarction. Of the 38 (90.4%) patients followed up (median 18m), 20 (52.6%) had a follow-up investigation. One patient (2.6%) had postoperative dysphagia, and 3 (7.8%) had postoperative heartburn. Five (11.9%) had recurrence. Symptom outcome was Visick grades I/II (86.8%), III (10.5%), and IV (2.6%).
CONCLUSION: Laparoscopic repair of PEH resulted in a short length of stay, excellent outcome in almost 87% of patients, and an overall recurrence rate of 11.9%.