Background: Dyspnoea in patients with a para-oesophageal hernia (PEH) occurs in 7% to 32% of cases and is very disabling, especially in elderly patients, and its origin is not well defined. The present study aims to assess the impact of PEH repair on dyspnoea and respiratory function.
Methods: From January 2019 to May 2021, all consecutive patients scheduled for PEH repair presenting with a modified Medical Research Council (mMRC) score ≥ 2 for dyspnoea were included. Before and 2 months after surgery, dyspnoea was assessed by both the dyspnoea visual analogue scale (DVAS) and the mMRC scale, as well as pulmonary function tests (PFTs) by plethysmography.
Results: All 43 patients that were included had pre- and postoperative dyspnoea assessments and PFTs. Median age was 70 years (range 63-73.5 years), 37 (86%) participants were women, median percentage of the intrathoracic stomach was 59.9% (range 44.2-83.0%), and median length of hospital stay was 3 days (range 3-4 days). After surgery, the DVAS decreased statistically significant (5.6 [4.7-6.7] vs. 3.0 [2.3-4.4], p < 0.001), and 37 (86%) patients had a clinically significant decrease in mMRC score. Absolute forced expiratory volume in one second (FEV1), total lung capacity, and forced vital capacity also statistically significantly increased after surgery by an average of 11.2% (SD 17.9), 5.0% (SD 13.9), and 10.7% (SD 14.6), respectively. Furthermore, from the subgroup analysis, it was identified that patients with a lower preoperative FEV1 were more likely to have improvement in it after surgery. No correlation was found between improvement in dyspnoea and FEV1. There was no correlation between the percentage of intrathoracic stomach and dyspnoea or improvement in PFT parameters.
Conclusion: PEH repair improves dyspnoea and FEV1 in a statistically significant manner in a population of patients presenting with dyspnoea. Patients with a low preoperative FEV1 are more likely to have improvement in it after surgery.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216289 | PMC |
| http://dx.doi.org/10.1007/s00464-022-09127-8 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Towards Clinical Application: Calcium Waves for In Vitro Qualitative Assessment of Propagated Primary Human Corneal Endothelial Cells.
Cells
December 2024
Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore.
Corneal endothelium cells (CECs) regulate corneal hydration between the leaky barrier of the corneal endothelium and the ionic pumps on the surface of CECs. As CECs do not regenerate, loss of CECs leads to poor vision and corneal blindness. Corneal transplant is the only treatment option; however, there is a severe shortage of donor corneas globally.
View Article and Find Full Text PDFHiatal hernia (HH), or type I paraoesophageal hernias (PEH), can commonly be grouped along with types II-IV PEHs. The fundamental operation performed for repair is similar for all types. We question whether the clinical outcomes following surgical repair differ.
View Article and Find Full Text PDFPatient reported outcomes and decision regret scores in redo-paraesophageal hernia repair.
Surg Endosc
December 2024
Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Introduction: Recurrent paraesophageal hernia (PEH) repair presents significant technical challenges, with limited data weighing the benefit to the operative risk. This study aims to describe our experience with recurrent PEH repair, including long-term surgical and patient reported outcomes (PROs).
Methods: We conducted a retrospective review of recurrent PEH repairs from June 2018-March 2023 using our institutional database.
Fundoplication at the time of paraesophageal hernia repair does not decrease the rate of hernia recurrence or postoperative reflux.
Surg Endosc
January 2025
Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7, Cleveland, OH, 44106, USA.
Background: Fundoplication at the time of paraesophageal hernia (PEH) repair is thought to help prevent the development or persistence of postoperative gastroesophageal reflux (GERD) and might also prevent hernia recurrence. However, the published data is not strong enough to definitively recommend this approach. This study was designed to evaluate the effectiveness and complications of a fundoplication at the time of paraesophageal hernia repair.
View Article and Find Full Text PDFOutcomes after revisional surgery for paraesophageal hernias at a high-volume tertiary care center.
Surg Endosc
December 2024
Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, L8 505-1650 Cedar Ave, Montreal, QC, H3G 1A4, Canada.
Article Synopsis
- Repairing recurrent giant paraesophageal hernias (PEH) has a higher complication rate than initial surgeries, which leads to hesitation in performing these procedures unless patients are symptomatic.
- A study analyzed outcomes of revisional PEH repairs compared to primary repairs, focusing on patient demographics and recovery times between 2012 and 2019.
- The research found that while revisional surgeries faced more complications, longer recovery times, and a higher conversion rate to open surgery, the incidence of severe complications was similar to those undergoing primary repairs.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!