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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 4  |  Page : 259-263

Minimally invasive therapy of upside-down stomach: A single-center experience


1 Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc; University Hospital Olomouc, Olomouc, Czech Republic
2 Department of Social Medicine and Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
3 Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic

Correspondence Address:
Martin Lovecek
Department of Surgery I, University Hospital Olomouc, I.P. Pavlova 6, 77520 Olomouc
Czech Republic
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_43_17

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Introduction: The aim of this study is to evaluate short-term and long-term outcomes of minimally invasive therapy in Type IV hiatal hernia (upside-down stomach). Patients and Methods: A retrospective study of 58 consecutively operated patients with Type IV hiatal hernia between 1998 and 2015 was conducted. Short-term outcome was evaluated using Clavien-Dindo classification and long-term outcomes using phone survey and subjective assessment of patients at least 1 year following surgery. Results: Laparoscopic hiatoplasty was performed in all patients, with gastropexy in 55.2%, fundoplication in 39.6%, and combination of fundoplication and gastropexy in 5.2%. Complications were observed in 6.9%. Two early reoperations (within 30 days) due to acute reherniation were necessary. Adverse events occurred in seven cases – pleural opening and peroperative bleeding. Three patients were reoperated laparoscopically 2–17 months after the first surgery due to receiving partial stomach herniation. In 67.2% of patients, long-term subjective quality of life assessment was available. Eighty percent of them were completely satisfied, without recurrence of preoperative symptoms. Conclusion: Elective laparoscopic surgery of hiatal hernia Type IV is a safe procedure, which has all the benefits of minimally invasive therapy with favorable short- and long-term results.


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