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Erschienen in: European Surgery 4/2018

25.04.2018 | short communication

Mechanisms of dyspnoea in giant hiatus hernia: an indication to perform surgery?

verfasst von: MBBS FRACS FRCS Gregory Leighton Falk, B. AVBS (Hons) Sophia C. Little

Erschienen in: European Surgery | Ausgabe 4/2018

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Summary

Background

The physiology of dyspnoea associated with giant hiatus hernia has not been well understood; however, it is generally considered a contraindication for surgery.

Methods

Recent studies into mechanisms and prevalence of dyspnoea are discussed.

Results

Recent studies suggest that dyspnoea is present in 80% of cases of massive hiatus hernia. Cardiac compression from massive hiatus hernia is a known contributor to dyspnoea in this patient group, as well as pulmonary aspiration.

Conclusions

Paradoxically, dyspnoea could be considered as an indication for surgery in patients presenting with giant hiatus hernia, once the mechanism is established.

Novel points

Dyspnoea in the presence of a substantially large hiatus hernia has long been considered unrelated and a contraindication to surgery. We present the results of varied studies that suggest dyspnoea, when the mechanism is established, is in fact an indication for surgery in giant hiatus hernia.
Literatur
1.
Zurück zum Zitat Low DE, Simchuk EJ. Effect of paraesophageal hernia repair on pulmonary function. Ann Thorac Surg. 2002;74(2):333–7. CrossRefPubMed Low DE, Simchuk EJ. Effect of paraesophageal hernia repair on pulmonary function. Ann Thorac Surg. 2002;74(2):333–7. CrossRefPubMed
2.
Zurück zum Zitat Zhu JC, Becerril G, Marasovic K, Ing AJ, Falk GL. Laparoscopic repair of large hiatal hernia: impact on dyspnoea. Surg Endosc. 2011;25(11):3620–6. CrossRefPubMed Zhu JC, Becerril G, Marasovic K, Ing AJ, Falk GL. Laparoscopic repair of large hiatal hernia: impact on dyspnoea. Surg Endosc. 2011;25(11):3620–6. CrossRefPubMed
3.
Zurück zum Zitat Naoum C, Falk GL, Ng ACC, et al. Left atrial compression and the mechanism of exercise impairment in patients with a large hiatal hernia. J Am Coll Cardiol. 2011;58(15):1624–34. CrossRefPubMed Naoum C, Falk GL, Ng ACC, et al. Left atrial compression and the mechanism of exercise impairment in patients with a large hiatal hernia. J Am Coll Cardiol. 2011;58(15):1624–34. CrossRefPubMed
4.
Zurück zum Zitat Carrott PW, Hong J, Kuppusamy M, Koehler RP, Low DE. Clinical ramifications of giant paraesophageal hernias are Underappreciated: making the case for routine surgical repair. Ann Thorac Surg. 2012;94(2):421. CrossRefPubMed Carrott PW, Hong J, Kuppusamy M, Koehler RP, Low DE. Clinical ramifications of giant paraesophageal hernias are Underappreciated: making the case for routine surgical repair. Ann Thorac Surg. 2012;94(2):421. CrossRefPubMed
5.
Zurück zum Zitat Naoum C, Kritharides L, Thomas L, et al. Modulation of phasic left atrial function and left ventricular filling in patients with extrinsic left atrial compression by hiatal hernia. Int J Cardiol. 2014;176(3):1176–8. CrossRefPubMed Naoum C, Kritharides L, Thomas L, et al. Modulation of phasic left atrial function and left ventricular filling in patients with extrinsic left atrial compression by hiatal hernia. Int J Cardiol. 2014;176(3):1176–8. CrossRefPubMed
6.
Zurück zum Zitat Naoum C, Puranik R, Falk GL, Yiannikas J, Kritharides L. Postprandial left atrial filling is impaired in patients with large hiatal hernia and improves following surgical repair. Int J Cardiol. 2015;182:291–3. CrossRefPubMed Naoum C, Puranik R, Falk GL, Yiannikas J, Kritharides L. Postprandial left atrial filling is impaired in patients with large hiatal hernia and improves following surgical repair. Int J Cardiol. 2015;182:291–3. CrossRefPubMed
7.
Zurück zum Zitat Naoum C, Kritharides L, Ing A, Falk GL, Yiannikas J. Changes in lung volumes and gas trapping in patients with large hiatal hernia. Clin Respir J. 2017;11(2):139–50. CrossRefPubMed Naoum C, Kritharides L, Ing A, Falk GL, Yiannikas J. Changes in lung volumes and gas trapping in patients with large hiatal hernia. Clin Respir J. 2017;11(2):139–50. CrossRefPubMed
8.
Zurück zum Zitat Mugino M, Little SC, Falk GL. Unpublished. 2018. Mugino M, Little SC, Falk GL. Unpublished. 2018.
9.
Zurück zum Zitat Le Page PA, Furtado R, Hayward M, et al. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl. 2015;97(3):188–93. CrossRefPubMedPubMedCentral Le Page PA, Furtado R, Hayward M, et al. Durability of giant hiatus hernia repair in 455 patients over 20 years. Ann R Coll Surg Engl. 2015;97(3):188–93. CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Gibson SC, Wong SC, Dixon AC, Falk GL. Laparoscopic repair of giant hiatus hernia: prosthesis is not required for successful outcome. Surg Endosc. 2013;27(2):618–23. CrossRefPubMed Gibson SC, Wong SC, Dixon AC, Falk GL. Laparoscopic repair of giant hiatus hernia: prosthesis is not required for successful outcome. Surg Endosc. 2013;27(2):618–23. CrossRefPubMed
Metadaten
Titel
Mechanisms of dyspnoea in giant hiatus hernia: an indication to perform surgery?
verfasst von
MBBS FRACS FRCS Gregory Leighton Falk
B. AVBS (Hons) Sophia C. Little
Publikationsdatum
25.04.2018
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2018
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-018-0531-3