[Para-esophageal hernias. Apropos of 42 cases].

J Chir (Paris)

Service de Chirurgie Abdominale et Thoracique, Hôpital Pasteur, Nice.

Published: December 1995

AI Article Synopsis

  • 42 patients (11 males, 31 females, mean age 72.8 years) underwent surgery for paraoesophageal hiatal hernia, with a majority experiencing digestive, respiratory, and cardiac symptoms over an average of 64 months.
  • Complications occurred in 18 patients, including acute obstruction and hemorrhage, with no postoperative deaths recorded and a total complication rate of 14.9%.
  • After a mean follow-up of 40.5 months, 87.5% of patients had very good functional outcomes, particularly those who underwent elective or deferred emergency surgeries; the Nissen-Rossetti procedure was found to be effective with no long-term issues.

Article Abstract

Between 1979 and May 1994, 42 patients (11 males, 31 females, mean age 72.8 +/- 12.4 years) underwent surgery for paraoesophageal hiatal hernia. In 37 cases, clinical signs had been observed for 64 months on the average: digestive (32), respiratory (15), cardiac (9). Nine patients had iron deficiency anaemia. Eighteen patients had a complication (acute obstruction: 10, haemorrhage: 6, perforation: 2, lung infection: 2). In 5 cases, the complication was the inaugural sign. Surgery was performed in a emergency situation in 5 cases and deferred emergency in 12 and surgery was elective in 25. An antireflux procedure was used in 36 cases (Lortat-Jacob (2), Toupet (5), Dor (2), Nissen-Rossetti (27)). Another procedure was also needed in 12 patients. There were no postoperative deaths and complications occurred in 6 patients (14.9%). Outcome was known in 40 patients with a mean follow-up of 40.5 months (range 3 to 140 months). Functional results was very good in 35 patients (87.5%), good in 3 (7.5%) and poor in 2 (5%). The most satisfactory immediate results were obtained for patients who had elective surgery and in those with a deferred emergency. Use of the Nissen-Rossetti procedure did not have any deleterious effect on these results and no long-term inconveniences.

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