Title of article :
Systematic use of gastric fundoplication in laparoscopic repair of paraesophageal hernias
Author/Authors :
Fernando Casabella، نويسنده , , Mika Sinanan، نويسنده , , Santiago Horgan، نويسنده , , Carlos A. Pellegrini، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1996
Pages :
5
From page :
485
To page :
489
Abstract :
Background Early surgical treatment has been recommended in patients with paraesophageal hiatal hernias. Recently, the laparoscopic approach has emerged as an ideal way to perform the operation. But whether or not an antireflux procedure should be done remains controversial. Patients and Methods: Four patients with type II and eleven with type III hiatal hernias were treated. Twelve of them manifested symptoms of reflux preoperatively. The operative technique consisted of resection of the sac, closure of the crura and gastric fundoplication, anchored to the diaphragm. Results All but two patients were completed laparoscopically. Mean operative time was 320 (±49 SD) minutes, and mean hospital stay was 3 (±1.2 SD) days. Early postoperative complications were subcutaneous emphysema (two patients) and atrial fibrillation (one patient). At one year all patients were asymptomatic without disphagia, reflux, or recurrence of the hernia. Conclusion The addition of fundoplication to paraesophageal hernia repair restores competency of the sphincter in patients with reflux associated to the hernia and prevents postoperative gastroesophageal reflux that results from the extensive dissection required. In addition, it provides an ideal means of fixing the stomach in the subdiaphragmatic position, decreasing the long term-risk of recurrence.
Journal title :
The American Journal of Surgery
Serial Year :
1996
Journal title :
The American Journal of Surgery
Record number :
619711
Link To Document :
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