Laparoscopic repair of giant paraesophageal hernia.
Giant paraesophageal hernias (PEHs) account for less than 5% of all hiatal hernias. In contrast to the small type I hiatal hernia, nonsurgical management of giant PEHs may be associated with progression of symptoms and life-threatening complications including hemorrhage, strangulation, and death. Most giant PEHs are associated with a current or previous history of gastroesophageal reflux disease and represent progression of the typical type I hernia to a type III hernia. Conventional open repair is associated with good results and low mortality but also with a significant morbidity and a delay in return to routine activities in this frequently elderly population. Recently, short-term outcome studies have reported that minimally invasive approaches to PEH may be associated with less morbidity, shorter hospital stay, faster recovery, and excellent clinical results.
Buenaventura
P O
PO
Section of Thoracic Surgery and the Minimally Invasive Surgery Center, UPMC Health System, Pittsburgh, PA, USA.
Schauer
P R
PR
Keenan
R J
RJ
Luketich
J D
JD
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000601:surgery*; D015391:Gastroplasty / Q000379:methods*; D006356:Heartburn / Q000209:etiology; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D012720:Severity of Illness Index; D016896:Treatment Outcome