OBJECTIVES: The misdiagnosis of short oesophagus may occur on recurrence of the hernia after surgery for type II-IV hiatal hernia (HH). The frequency of short oesophagus in type II-IV hernia is undefined. The aim of this study was to assess the frequency of true short oesophagus in patients undergoing surgery for type II-IV hernia. METHODS: Thirty-four patients with type II-IV hernia underwent minimally invasive surgery. After full isolation of the oesophago-gastric junction, the position of the gastric folds was localized endoscopically and two clips were applied in correspondence. The distance between the clips and the diaphragm (intra-abdominal oesophageal length) was measured. When the intra-abdominal oesophagus was <1.5 cm after oesophageal mobilization, the Collis procedure was performed. After surgery, patients underwent a follow-up, comprehensive of barium swallow and endoscopy. RESULTS: After mediastinal mobilization (median 10 cm), the intra-abdominal oesophageal length was >1.5 cm in 17 patients (4 type II, 11 type III and 2 type IV) and ≤ 1.5 cm in 17 patients (13 type III and 4 type IV hernia). No statistically significant differences were found between patients with intra-abdominal oesophageal length > or ≤ 1.5 cm with respect to symptoms duration and severity. Global results (median follow-up 48 months) were excellent in 44% of patients, good in 50%, fair in 3% and poor in 3%. HH relapse occurred in 3%. CONCLUSIONS: True short oesophagus is present in 57% of type III-IV and in none of type II HHs. The intraoperative measurement of the submerged intra-abdominal oesophagus is an objective method for recognizing these patients.
The frequency of true short oesophagus in type II-IV hiatal hernia / Lugaresi, M; Mattioli, S; Aramini, B; D'Ovidio, F; Di Simone, MP; Perrone, O.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 43:2(2013), pp. 30-36.
|Data di pubblicazione:||2013|
|Data di prima pubblicazione:||feb-2013|
|Titolo:||The frequency of true short oesophagus in type II-IV hiatal hernia.|
|Autore/i:||Lugaresi, M; Mattioli, S; Aramini, B; D'Ovidio, F; Di Simone, MP; Perrone, O.|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/ejcts/ezs602|
|Codice identificativo ISI:||WOS:000313829300001|
|Codice identificativo Scopus:||2-s2.0-84872736065|
|Codice identificativo Pubmed:||23186837|
|Citazione:||The frequency of true short oesophagus in type II-IV hiatal hernia / Lugaresi, M; Mattioli, S; Aramini, B; D'Ovidio, F; Di Simone, MP; Perrone, O.. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - 43:2(2013), pp. 30-36.|
|Tipologia||Articolo su rivista|
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