title: Simultaneous laparoscopic Nissen fundoplication and percutaneous endoscopic gastrostomy to treat an elderly patient with a large paraesophageal hernia: a case report.
abstract: Laparoscopic Nissen fundoplication (LNF) and gastrostomy are often performed in children with gastroesophageal reflux disease. With a population that is increasingly aging, the number of elderly patients with paraesophageal hernia who have a nutritional disorder due to dysphagia has increased. In these patients with feeding difficulties, LNF and percutaneous endoscopic gastrostomy (PEG) are effective procedures for providing nutritional support. Here, we describe the case of an 82-year-old woman with paraesophageal hernia and certain comorbidities. She was receiving enteral feeding through a nasogastric tube, which was discontinued because aspiration pneumonia occurred. Therefore, LNF and crural repair without mesh placement were performed. The PEG tube was placed using the Ponsky pull technique under direct visualization with a laparoscope and gastroscope. The patient's nutritional status improved after she received enteral nutrition through the PEG tube. Thus, LNF and PEG may be useful techniques for nutritional support in elderly patients with a large paraesophageal hernia.
authors.affiliation: Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Kida
authors.forename: Nobutada
authors.initials: N
authors.lastname: Fukino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000369:Aged, 80 and over; D015897:Comorbidity; D003952:Diagnostic Imaging; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*
keywords: Laparoscopic Nissen fundoplication; paraesophageal hernia; percutaneous endoscopic gastrostomy