Laparoscopic surgery into mixed hiatal hernia. Results pre-operative and post-operative.

Abstract

[eng] Introduction: the complications of the mixed hernia need, of- ten, surgical treatment. In the asymtomatic patients this one treat- ment is controversial, due to her complex repair and the high per- centage of relapse informed in the long term. The surgical classic routes, they present raised morbi-mortality related to the extent of the incisions, to long hospitable stays and slow recovery. Material and methods: between October, 2001 to Novem- ber, 2007 we check 39 patients with hernia hiatal mixed with a middle ages of 65 years (35-78 years). In Lloyd-Davies's position, the content diminishes hernia and the redundant sack is resected. The diaphragmatic props are sutured by material not reab- sorbable. Mesh of reinforcement intervened in 7/39 repairs. It concludes with a partial or complete antirreflux depending on the report. Results: the operative average time was of 126 min; the hos- pital stay of 2.46 days. The complications perioperatives are prin- cipally cardiorespiratory. A patient died for an intestinal inadver- tent perforation during the intervention and of late diagnosis. We realize traffic gastroduodenal to 12 months in 28 patients (71.7%). We find relapse in 8 patients (20.5%). Four asymtomatic patients, with chance find in the radiological control. Three pa- tients with pirosis that needs treatment and one of the relapses needed reintervention for strangulation of a gastric volvulus. Conclusions: the laparoscopic surgery offers safety and effi- ciency with rapid postoperatory recovery, minor morbidity and hospitable stay. After the surgery, the long-term relapse presents similar results to the opened surgery, though the interposition of mesh can propitiate her decrease.