Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

被引:11
作者
Addo, Alex [1 ]
Broda, Andrew [1 ]
Reza Zahiri, H. [1 ]
Brooks, Ian M. [1 ]
Park, Adrian [1 ,2 ]
机构
[1] Anne Arundel Med Ctr, Dept Surg, 2000 Med Pkwy,Belcher Pavil,Suite 106, Annapolis, MD 21401 USA
[2] Johns Hopkins Univ, Sch Med, Baltimore, MD 21218 USA
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2020年 / 34卷 / 07期
关键词
Cameron's lesions; Hiatal hernia; Anemia resolution; Paraesophageal hernia; Quality of life outcomes; Hiatal hernia repair; Antireflux surgery; Fundoplication; IRON-DEFICIENCY ANEMIA; LARGE DIAPHRAGMATIC-HERNIA; LINEAR GASTRIC-EROSION; RELIABILITY; PREVALENCE;
D O I
10.1007/s00464-019-07054-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Cameron lesions (CL) are common complications of large hiatal hernia (HH) disease and are known to result in chronic blood loss with resultant microcytic anemia. There is support in the literature that repair of HH may lead to resolution of CL and restore normal hemoglobin levels. This study aimed to determine the impact of elective HH repair on resolution of anemia and the quality of life (QOL) in patients with CL. Method A single-institution, retrospective review analyzed all patients with history of CL or anemia (hemoglobin < 12.0 gm/dl in women, < 13.5 gm/dl in men) who underwent HH repair from January 2012 to May 2019. Four validated surveys were used to assess QOL: Reflux Symptom Index (RSI), gastroesophageal reflux disease health-related QOL (GERD-HRQL), laryngopharyngeal reflux health-related QOL (LPR-HRQL), and QOL and swallowing disorders (SWAL) survey. History of iron supplements and perioperative hemoglobin were also noted. Result Ninety-six patients were included in this study. The mean age was 67.4 +/- 10.8 years and 79% of patients were female. CL were endoscopically identified in 61.5% of patients preoperatively, and the rest of the patients experienced anemia of undiagnosed origin but had a high suspicion for CL. Mean follow-up after HH repair was 17.3 months (range, 1 month-5 years). Mean preoperative hemoglobin was 11.01 +/- 2.9 gm/dl and 13.23 +/- 1.6 gm/dl postoperatively (p < 0.01). Forty-two (73.7%) patients had resolution of anemia during follow-up and 94.5% stopped supplemental oral iron. Finally, QOL scores significantly improved after surgical intervention: RSI (63%), GERD-HRQL (77%), LPR-HRQOL (72%), and SWAL (13%). Conclusion Elective HH repair in patients with chronic anemia secondary to CL may potentially resolve CL and anemia and contribute to significant QOL improvements. Future studies will prospectively assess the resolution of CL with biochemical and endoscopic follow-up to confirm the preliminary findings of our analysis.
引用
收藏
页码:3072 / 3078
页数:7
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