title: [Hiatal hernias: why and how should they be surgically treated].
abstract: BACKGROUND
  There is controversy in the literature about the choice of expectant medical treatment versus surgical treatment of hiatal hernias, depending on the presence or absence of symptoms. This study presents the results obtained by our group, considering disease duration and postoperative results.
  
  
  METHODS
  A total of 121 patients were included and divided by age, disease duration, type of hiatal hernia and postoperative outcome.
  
  
  RESULTS
  In 32% of the patients younger than 70 years, symptom duration was longer than 11 years and 68% of those aged more than 71 years had long-term symptoms (p<.05). Type iv hernias (complex) and those with diameters measuring more than 16 cm were observed in the group with longer symptom duration. Complications were more frequent in the older age group, in those with longer symptom duration and in those with type iv complex hernias. There was no postoperative mortality and only one patient (0.8%) with a type iii hernia and severe oesophagitis required reoperation.
  
  
  CONCLUSIONS
  We recommend that patients with hiatal hernia undergo surgery at diagnosis to avoid complications and risks. Older patients should not be excluded from surgical indication but should undergo a complete multidisciplinary evaluation to avoid complications and postoperative mortality.
authors.affiliation: Departamento de Cirugía, Hospital Clínico Dr. José J. Aguirre, Facultad de Medicina, Universidad de Chile, Santiago, Chile. cirugia@braghetto.cl
authors.forename: Italo
authors.initials: I
authors.lastname: Braghetto
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Owen
authors.initials: O
authors.lastname: Korn
authors.forename: Maher
authors.initials: M
authors.lastname: Musleh
authors.forename: Enrique
authors.initials: E
authors.lastname: Lanzarini
authors.forename: Alex
authors.initials: A
authors.lastname: Saure
authors.forename: Baydir
authors.initials: B
authors.lastname: Hananias
authors.forename: Héctor
authors.initials: H
authors.lastname: Valladares
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods* / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Hernia hiatal; Hiatal hernia; Laparoscopia; Laparoscopy; Tratamiento; Treatment