Laparoscopic Hiatal Repair and Gastropexy without Fundoplication of Hiatal Hernia in Elderly Patients with High Dysphagia Score: A Case Series of Four Patients
Abstract
ABSTRACT INTRODUCTION Hiatal repair with fundoplication for hiatal hernia (HH) could cause postoperative dysphagia. In the aging society, the number of patients with HH type III/IV and severe dysphagia is increasing. In this case, the surgical priority is to resolve the dysphagia. Recent papers have reported that laparoscopic hiatal repair without fundoplication can be an alternative procedure. Nevertheless, the indication for hiatal repair without fundoplication should be carefully considered. CASE PRESENTATION We performed laparoscopic hiatal repair and gastropexy without fundoplication in four patients with HH type III and high dysphagia scores. The median age was 84 (range 81–96) years, and the median values in the updated Charlson Comorbidity Index (uCCI) were 2 (2–5). Dysphagia scores were high (3, n = 2 and 4, n = 2). The media operative time was 196 (57–249) minutes, and the postoperative hospital stay was 9.5 (8–12) days. Only one case experienced HH recurrence (Type I) on endoscopy and computed tomography but did not have heartburn or dysphagia while on medication. The FSSG scores significantly decreased from 29 (26–35) to 4 (0–7) after surgery (p = 0.0035). Compared with those of four patients who underwent conventional surgeries (hiatal repair with Nissen fundoplication) during the same period, patients undergoing hiatal repair and gastropexy without fundoplication were relatively older (84 [81–96] vs. 74.5 [72–79]), had higher uCCI values (2 [2–5] vs. 1 [0–2]),…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- In silico toxicology protocols
- QM7-X, a comprehensive dataset of quantum-mechanical properties spanning the chemical space of small organic molecules
- Quantum Informed Machine-Learning Potentials for Molecular Dynamics Simulations of CO2's Chemisorption and Diffusion in Mg-MOF-74
- In-silico strategies in nano-drug design: Bridging nanomaterials and pharmacological applications
- mRNA codon optimization with quantum computers
- The computational power of the human brain
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.