Abstract:
Objective
To investigate the clinical characteristics of short esophageal hiatal hernia(SEHH) and the safety and efficacy of hiatal hernia repair combined with Nissen fundoplication for the treatment of SEHH.
Methods
Clinical data, preoperative examination results, intraoperative and postoperative conditions, follow-up information of 8 SEHH patients admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from October 2023 to April 2024 were collected. The clinical characteristics and the safety and surgical effect for SEHH were analyzed.
Results
Among the 8 patients,there were 5 males and 3 females. Age (59.5±9.0) years, body mass index (30.0±2.53) kg/m2, hemoglobin(64-140) g/L, mean (90±27) g/L, 7 patients had anemia. All patients showed SEHH on upper gastrointestinal imaging. CT showed a hernia sac volume of 373 (262-537) cm3, a transverse diameter of the hiatus of (4.4±0.53) cm, a Gastroesophageal reflux disease questionnaire (Gerd Q) score of (10.6±1.92)points, high resolution esophageal manometry (HREM) indicating a hiatus hernia diameter of (6.8±1.80)cm, a DeMeester score of 32.8 (15.2-50.6) points, and an esophageal length coefficient of 18.3±0.67.Intraoperative measurements revealed that the distance between the gastroesophageal junction and the hiatus is (2.5±0.16) cm. All 8 patients underwent HHR combined with Nissen fundoplication, with 3 cases performed by robots and 5 cases performed by laparoscopy. Two cases underwent combined cholecystectomy, and one case underwent combined incisional hernia repair. The surgical duration was(173±79) minutes, intraoperative bleeding was 20-150 ml, and postoperative hospital stay was 3-13 days.All 8 patients with SEHH were successfully discharged and followed up for 4-10 months after surgery. The symptoms of acid reflux and heartburn disappeared in all patients, and dysphagia did not occur. No recurrence of hiatal hernia (HH) was observed.
Conclusion
The clinical symptoms of patients with SEHH are similar to those of patients with HH, and most of them are accompanied by anemia. Laparoscopic or robot assisted hiatal hernia repair with Nissen fundoplication is safe and effective treatment for SEHH, with good short-term follow-up results.
Key words:
Short esophageal,
Hernia, hiatal,
Gastroesophageal junction,
Upper gastrointestinal radiography
Maimaitiming Maimaitiaili, Hao Wang, Aili Aikebaier, Abudureyimu Kelimu. Clinical characteristics and efficacy analysis of short esophageal hiatal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 518-522.