PURPOSE: Management of emergently admitted patients due to a complicated large paraesophageal hernia with acute symptoms of an "intrathoracic stomach" is controversial. The aim of this study was to clarify whether emergency surgery in such cases should be the procedure of choice. METHODS: The retrospective analysis of patients who were hospitalized due to emerging acute symptoms of an "intrathoracic stomach" between January 2009 and May 2013 was used as method. Patients were categorized into three groups: emergency operation within 24 h after admission, semi-elective operation within the first 7 days after admission and elective operation. RESULTS: Twenty-four patients were identified. Only three (12.5 %) patients required laparoscopic emergency surgery and two incurred a perioperative complication. In consequence of persistent or early recurrent complaints a laparoscopic operation was required prior to discharge semi-elective in 6/24 (25 %) patients without complications. The remaining 15/24 (62.5 %) patients were free of complaints after conservative therapy, but all of them decided upon elective operation after informed consent. One minor complication occurred. CONCLUSION: The majority of patients with acute symptoms due to an intrathoracic stomach can primarily be treated conservatively and timing of elective repair should be performed after resuscitation in a center of laparoscopic antireflux surgery.
PURPOSE: Management of emergently admitted patients due to a complicated large paraesophageal hernia with acute symptoms of an "intrathoracic stomach" is controversial. The aim of this study was to clarify whether emergency surgery in such cases should be the procedure of choice. METHODS: The retrospective analysis of patients who were hospitalized due to emerging acute symptoms of an "intrathoracic stomach" between January 2009 and May 2013 was used as method. Patients were categorized into three groups: emergency operation within 24 h after admission, semi-elective operation within the first 7 days after admission and elective operation. RESULTS: Twenty-four patients were identified. Only three (12.5 %) patients required laparoscopic emergency surgery and two incurred a perioperative complication. In consequence of persistent or early recurrent complaints a laparoscopic operation was required prior to discharge semi-elective in 6/24 (25 %) patients without complications. The remaining 15/24 (62.5 %) patients were free of complaints after conservative therapy, but all of them decided upon elective operation after informed consent. One minor complication occurred. CONCLUSION: The majority of patients with acute symptoms due to an intrathoracic stomach can primarily be treated conservatively and timing of elective repair should be performed after resuscitation in a center of laparoscopic antireflux surgery.
Authors: Geoffrey Paul Kohn; Raymond Richard Price; Steven R DeMeester; Jörg Zehetner; Oliver J Muensterer; Ziad Awad; Sumeet K Mittal; William S Richardson; Dimitrios Stefanidis; Robert D Fanelli Journal: Surg Endosc Date: 2013-09-10 Impact factor: 4.584
Authors: Stavros A Antoniou; George A Antoniou; Oliver O Koch; Rudolph Pointner; Frank A Granderath Journal: Surg Laparosc Endosc Percutan Tech Date: 2012-12 Impact factor: 1.719
Authors: Rudolf J Stadlhuber; Amr El Sherif; Sumeet K Mittal; Robert J Fitzgibbons; L Michael Brunt; John G Hunter; Tom R Demeester; Lee L Swanstrom; C Daniel Smith; Charles J Filipi Journal: Surg Endosc Date: 2008-12-06 Impact factor: 4.584
Authors: Marek Polomsky; Rui Hu; Boris Sepesi; Matthew O'Connor; Xing Qui; Daniel P Raymond; Virginia R Litle; Carolyn E Jones; Thomas J Watson; Jeffrey H Peters Journal: Surg Endosc Date: 2009-12-24 Impact factor: 4.584