Figure 1. Type IV hiatal hernia with stomach and colon in the chest. Left lobe of the liver reflected cephalad.
| Journal of Current Surgery, ISSN 1927-1298 print, 1927-1301 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Curr Surg and Elmer Press Inc |
| Journal website http://www.currentsurgery.org |
Original Article
Volume 6, Number 1, March 2016, pages 6-13
Different Biologic Grafts for Diaphragmatic Crura Reinforcement During Laparoscopic Repair of Large Hiatal Hernia: A Six-Year Single Surgeon Experience
Figures
Tables
| Patient (n) | Gender | BMI | Age | Symptoms | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Epigastric pain | Chest pain | SOB | Dysphagia | Acid reflux | Nausea/vomiting | Hematemesis | Weight loss | ||||
| BMI: body mass index; SOB: shortness of breath. | |||||||||||
| 1 | M | 46 | 52 | Yes | Yes | Yes | Yes | Yes | Yes | No | No |
| 2 | F | 37 | 57 | Yes | Yes | No | Yes | Yes | No | No | No |
| 3 | F | 27 | 53 | Yes | Yes | Yes | Yes | No | No | No | No |
| 4 | F | 36 | 67 | Yes | Yes | No | Yes | Yes | Yes | No | No |
| 5 | M | 22 | 68 | No | Yes | No | No | Yes | No | yes | No |
| 6 | F | 31 | 51 | No | Yes | Yes | Yes | Yes | No | No | yes |
| 7 | F | 34 | 42 | Yes | Yes | No | No | Yes | No | No | No |
| 8 | M | 28 | 49 | No | No | Yes | Yes | No | No | No | No |
| 9 | M | 24 | 45 | No | Yes | No | Yes | No | No | No | No |
| 10 | M | 30 | 62 | Yes | Yes | Yes | Yes | No | Yes | No | No |
| 11 | F | 43 | 63 | Yes | Yes | Yes | Yes | Yes | Yes | yes | No |
| Total: 11 | M: 5 F: 6 | Mean ± SD: 32.5 ± 7.5 | Mean ± SD: 55.4 ± 8.7 | 64% | 91% | 55% | 82% | 64% | 4% | 2% | 1% |
| Patient (n) | Length of surgery (min) | Defect size (R to L) × (A × P), cm | Size (%) of stomach in the chest | Mesh type | Fundoplication | EBL (mL) | Complications | Mediastinal lipoma | Secondary operation | Hermia type | LOS (days) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EBL: estimated blood loss; LOS: length of stay; UHR: umbilical hernia repair. | |||||||||||
| 1 | 305 | 8 × 7 | 70 | Acell | Dor | 500 | Bleeding | Yes | No | 3 | 6 |
| 2 | 146 | 7 × 7 | 50 | Acell | Dor | 10 | No | No | No | 3 | 2 |
| 3 | 213 | 9 × 6 | 60 | Acell | No | 10 | No | No | No | 4 | 2 |
| 4 | 240 | 8 × 7 | 50 | Acell | Dor | 50 | No | No | No | 3 | 2 |
| 5 | 191 | 6 × 6 | 40 | AlloMax | Nissen | 50 | No | No | UHR | 3 | 2 |
| 6 | 320 | 9 × 6 | 100 | AlloMax | Dor | 10 | No | No | No | 4 | 4 |
| 7 | 207 | 8 × 6 | 40 | AlloMax | Dor | 10 | No | Yes | Lap chole | 2 | 6 |
| 8 | 370 | 8 × 5 | 80 | AlloMax | Dor | 50 | No | Yes | No | 3 | 4 |
| 9 | 171 | 7 × 6 | 40 | AlloMax | Dor | 10 | No | No | No | 3 | 1 |
| 10 | 315 | 9 × 8 | 50 | Permacol | Dor | 10 | No | Yes | No | 3 | 5 |
| 11 | 213 | 6 × 6 | 100 | AlloMax | Toupet | 10 | No | No | Lap chole | 3 | 2 |
| Total: 11 | Mean ± SD: 244.6 ± 71.7 | Mean ± SD: (7.7 ± 1.1) × (6.4 ± 0.8) | 62% | 6 + 4 + 1 = 11 | 8 + 1 + 1 + 1 = 11 | Mean ± SD: 65 ± 145.4 | 9% | 36% | 27% | 8 + 2 + 1 = 11 | Mean ± SD: 3.3 ± 1.8 |
| Patient (n) | Symptoms after surgery and postoperative complications | Postoperative evaluation | F/U (months) | Recurrence | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOB | Early dysphagia | Acid reflux | Persistent dysphagia | Gastroparesis | Parapneumonic effusion | CT | EGD | UGI | Clinical | Radiological | ||
| EGD: esophagogastroscopy; UGI: upper gastrointestinal; F/U: follow-up. | ||||||||||||
| 1 | No | No | No | No | No | No | No | No | No | 3 | No | n/a |
| 2 | No | No | No | No | No | No | Yes | No | No | 18 | No | No |
| 3 | No | No | No | No | No | No | No | No | Yes | 12 | No | No |
| 4 | Yes, resolved | No | No | No | No | No | No | No | No | 12 | No | n/a |
| 5 | No | Yes, resolved | No | No | No | No | Yes | No | No | 30 | No | No |
| 6 | Yes, resolved | No | No | No | No | Yes, aspirated | Yes | No | No | 40 | No | No |
| 7 | No | No | Yes | No | No | No | Yes | No | No | 6 | No | Yes |
| 8 | No | Yes, resolved | No | No | Yes | Yes, resolved | Yes | Yes | Yes | 24 | No | No |
| 9 | No | No | No | Yes, improved | No | No | No | Yes (balloon dilatation) | Yes | 6 | Yes | Yes |
| 10 | No | No | No | No | No | No | No | No | No | 6 | No | n/a |
| 11 | No | No | No | No | No | No | No | No | No | 6 | No | n/a |
| Total: 11 | 18% | 18% | 9% | 9% | 9% | 18% | 45% | 18% | 27% | Mean ± SD: 15.3 ± 12 | 9% | 18% |