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Hiatal hernia and anemia: a single-center experience
Andrés R Latorre-Rodríguez1, Raj Shah2, Hailey Simmonds2
1Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States; Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia.
Summary
Hiatal hernia (HH) repair significantly improves anemia and reduces the need for related therapies. Early surgical intervention is recommended for patients with anemia and Cameron lesions associated with hiatal hernias.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Anemia Management
Background:
- Hiatal hernia (HH) is an underrecognized cause of chronic anemia.
- The effectiveness of surgical HH repair (HHr) for anemia is not well-established.
- Cameron lesions are associated with HH and anemia.
Purpose of the Study:
- To assess anemia prevalence and Cameron lesions in HHr patients.
- To explore the relationship between hernia size and anemia.
- To evaluate postoperative anemia improvement after HHr.
Main Methods:
- Retrospective observational study of 132 patients undergoing primary HHr.
- Inclusion criteria: preoperative anemia, Cameron lesions, or iron deficiency anemia history.
- Exclusion criteria: prior foregut surgery or other bleeding sources.
- Primary endpoints: postoperative transfusion-level anemia and anemia-related therapies.
Main Results:
- Anemia-related findings increased with HH size (small 7.3% to large 58.4%).
- Postoperative transfusion-level anemia decreased significantly (15.2% to 0%, p=0.004).
- Anemia-related medical therapies reduced substantially (50.8% to 2.2%, p<0.001).
Conclusions:
- Anemia and Cameron lesions are common in HHr patients, correlating with hernia size.
- HHr effectively resolves transfusion-level anemia and reduces therapy needs.
- Early surgical referral is crucial as medical management alone may be insufficient.
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