Effect on iron deficiency anemia of laparoscopic repair of large paraesophageal hernias.
Patients with iron deficiency anemia sometimes have a large paraesophageal hernia and no other explanation for their chronic blood loss. The management of these patients can be a dilemma, especially when the hernia is otherwise asymptomatic. We aimed to determine whether a laparoscopic repair of the hernia could cure the anemia. We reviewed a consecutive series of 11 cases of iron deficiency anemia associated with a large paraesophageal hernia, many without associated linear gastric erosions, managed by laparoscopic repair and fundoplication. There was one conversion in a patient with dense adhesions from previous upper abdominal surgery. Another patient required a laparoscopic reoperation for an early recurrence. Major morbidity occurred in three patients and there was no mortality. There was no recurrence of anemia after a median follow-up of more than 2 years. Iron deficiency anemia in association with a large paraesophageal hernia can be treated by laparoscopic repair with acceptable morbidity and minimal mortality. The complications of a large paraesophageal hernia are also prevented.
Hayden
J D
JD
Department of Surgery, University of Adelaide and Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia.
Jamieson
G G
GG
D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006551:Hernia, Hiatal / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged