Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2020
Late-term hiatal hernia after gastric bypass: an emerging problem.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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.
Clapp Benjamin, Vo Loc-Uyen, Lodeiro Carlos, Harper Brittany, Montelongo Simon, Lee Isaac, Tyroch Alan
Аннотация
BACKGROUND: Gastric bypasses were the most common bariatric surgery for many years, and long-term complications after gastric bypass are known to be relatively common. Symptomatic hiatal hernia (HH) with pouch migration is a less-known complication. However, when these are symptomatic, they require surgical repair.
OBJECTIVE: We present a case series of late-term HH after gastric bypass and discuss the common presentation and treatment.
SETTING: University program in the United States.
METHODS: A retrospective chart review was performed of patients presenting with late-term HH after gastric bypass performed by a single surgeon during 2002 through 2018. The review captured presentation and symptoms, age, body mass index, time from index surgery, radiologic studies, and the reoperative details. If available, the original operative note was reviewed along with any preoperative imaging studies. A review of the literature was also performed.
RESULTS: Seven patients were included in the case series. The average time from the index surgery was 11.9 years (range 9-16) and the average age of the patient at time of presentation was 60.1. The average body mass index at the time of the HH repair was 34 kg/m2. The most common presenting symptom was gastroesophageal reflux. Both computed tomography and upper gastrointestinal series were used for diagnosis with a common finding of HH and pouch migration into the mediastinum. HH repair with bioabsorbable mesh was performed in all patients, with an average operative time of 105 minutes.
CONCLUSION: HH can present late after gastric bypass become symptomatic. When symptomatic, it needs to be addressed surgically and can usually be done through a minimally invasive approach.
OBJECTIVE: We present a case series of late-term HH after gastric bypass and discuss the common presentation and treatment.
SETTING: University program in the United States.
METHODS: A retrospective chart review was performed of patients presenting with late-term HH after gastric bypass performed by a single surgeon during 2002 through 2018. The review captured presentation and symptoms, age, body mass index, time from index surgery, radiologic studies, and the reoperative details. If available, the original operative note was reviewed along with any preoperative imaging studies. A review of the literature was also performed.
RESULTS: Seven patients were included in the case series. The average time from the index surgery was 11.9 years (range 9-16) and the average age of the patient at time of presentation was 60.1. The average body mass index at the time of the HH repair was 34 kg/m2. The most common presenting symptom was gastroesophageal reflux. Both computed tomography and upper gastrointestinal series were used for diagnosis with a common finding of HH and pouch migration into the mediastinum. HH repair with bioabsorbable mesh was performed in all patients, with an average operative time of 105 minutes.
CONCLUSION: HH can present late after gastric bypass become symptomatic. When symptomatic, it needs to be addressed surgically and can usually be done through a minimally invasive approach.