ArticleWorld journal of gastrointestinal surgery2023
Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor.
Article in World journal of gastrointestinal surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors at 4 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundGiant hernias present a significant challenge for digestive surgeons. The approach taken (laparoscopic
aimTo determine whether patients presenting inadequate laparoscopic access to the intrathoracic hernial sac obtain poorer postoperative results than those with no such problem, in order to assess the need for a thoracoscopic approach.
methodsFor the retrospective series of patients treated in our hospital for hiatal hernia (
resultsPatients with giant hiatal hernias for whom a preoperative calculation suggested that the laparoscopic route would not access all areas of the intrathoracic sac presented higher rates of perioperative complications and recurrence during follow-up than those for whom laparoscopy was unimpeded. The difference was statistically significant. Moreover, the insertion of mesh did not improve results for the non-accessible group.
conclusionFor patients with giant hiatal hernias, it is essential to conduct a preoperative evaluation of the angle of vision and the working area for surgery. When parts of the intrathoracic sac are inaccessible laparoscopically, the thoracoscopic approach should be considered.
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