Keywords:
Gastrointestinal tract, Stomach (incl. Oesophagus)
Authors:
S. Canovetti, P. Giusti, A. Sibilla, S. Giusti, C. Bartolozzi; Pisa/IT
DOI:
10.1594/ecr2010/C-1511
Purpose
Thanks to the improvement of laparoscopic surgical techniques, from the early 1990s we have been witnessing a shift in surgical approach, with reference to many pathologies, such as gallbladder calcolosis, hiatal and, by all means, paraesophageal hernia.
In particular, the advantages of laparoscopy, including the reduction of post operative pain and rapid convalescence, convinced surgeons to apply the laparoscopic approach in the treatment of giant paraesophageal hiatal hernias. Many studies were being done since that time, to evaluate the usefulness and feasibility of laparoscopy: in 2000 a report by Hashemi and colleagues from University of California pointed out a recurrence by 42% in a median time of 17 months (1), in 2004 Andujar JJ and co. pointed out a 5% of paraesophageal hernia recurrence , a 20% of sliding hernia recurrence and a 3% of wrap failure in a median time of 15 months; (2), in 2008 Nason and collegues pointed out a recurrence of 15% in a median time of 51 months (3). Each study had been carried out thanks to the contribution of Digital Fluoroscopy, which turned out to play a foundamental role in the evaluation of these patients, since it represents the most effective and easiest exam to evaluate local complications in the early and late post-operative period.
Our purpose is to evaluate the role of the usefulness of Digital Fluoroscopic (DF) swallow study in patients treated with laparoscopic repair of "giant" hiatal hernias with direct closure of the hiatus.