Related Experiment Videos
Dysphagia complicating hiatal hernia repair.
The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1984
Summary
Post-surgery dysphagia is a common issue after reflux control operations. Thorough investigation is key to diagnosing and treating swallowing difficulties caused by hiatal hernia surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Digestive System Surgery
Background:
- Dysphagia (difficulty swallowing) can persist or arise after surgical interventions for gastroesophageal reflux disease (GERD).
- Recurrent hiatal hernias often require surgical management, which may lead to or exacerbate swallowing problems.
Purpose of the Study:
- To investigate the incidence and causes of dysphagia following surgical repair of recurrent hiatal hernias.
- To evaluate the effectiveness of surgical revisions for managing post-operative dysphagia.
Main Methods:
- A retrospective review of 208 patients undergoing surgery for recurrent hiatal hernia.
- Diagnostic evaluation included patient history, radiology, esophageal manometry, and endoscopy.
- Surgical interventions for dysphagia included fundoplication gastroplasty, Nissen repair, colon interposition, and myotomy closure.
Main Results:
- Dysphagia was present in 34 (16.3%) patients post-operatively.
- Identified causes included reflux stricture, Nissen wrap issues, muscle injury, and inappropriate myotomy.
- Surgical correction resulted in 28 asymptomatic patients and five with improved but persistent dysphagia after an average 5.4-year follow-up.
Conclusions:
- Dysphagia is a significant complication of recurrent hiatal hernia surgery, with diverse underlying causes.
- Comprehensive diagnostic workup is essential for accurate identification of dysphagia etiology.
- Surgical revision can effectively manage post-operative dysphagia, leading to good long-term outcomes.