Aggressive Surgery of Hiatal Hernia

Purpose: To emphasize aggressive surgery in the treatment of hiatal hernia based on a personal experience. Materials and Methods: Twenty-four patients with hiatal hernia were surgically treated in a period of 9 years. They included 6 men and 18 women. The mean age was 76.5 years old (range 54~87). At referral, one had depended on ventilator for 47 days following a cardiopulmonary resuscitation, and other one had been treated by repeated blood transfusion for severe anemia. Seven others had coincidental surgical diseases. Results: These hiatal hernias were type-1 in 6, type-3 in 15, and type-4 in 3. Eight (33.3%) patients had a huge hiatal hernia. All patients underwent laparotomy repair of hiatal hernia. Of them, 6 underwent concomitant and one underwent subsequent surgical procedure to treat the coincidental surgical diseases. Including the concomitant procedures, the mean operation time was 122 minutes (range 60 to 315). The mean length of postoperative hospital stay was 7.65 days (range 4 to 24). There was no operative death or recurrence. Conclusion: Patients with hiatal hernia had health problems and potential coincident surgical diseases. Huge hiatal hernia usually induced cardiopulmonary compression even cardiac arrest. Aggressive surgical repair is mandatory