HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Victor F. Trastek Mark S. Allen Claude Deschamps Peter C. Pairolero Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Trastek, V. F. Articles by Thompson, A. Search for Related Content PubMed PubMed Citation Articles by Trastek, V. F. Articles by Thompson, A.

J Thorac Cardiovasc Surg 1996;112:1340-1345
© 1996 Mosby, Inc.

GENERAL THORACIC SURGERY

DIAPHRAGMATIC HERNIA AND ASSOCIATED ANEMIA: RESPONSE TO SURGICAL TREATMENT

From the Section of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minn.

Received for publication May 6, 1996 Revisions requested May 30, 1996; revisions received July 12, 1996 Accepted for publication July 15, 1996. Address for reprints: Victor F. Trastek, MD, 200 First St., SW, Rochester, MN 55905.

Abstract

From 1985 to 1993, 49 patients (35 women and 14 men) with diaphragmatic hernia and associated anemia underwent surgical repair. The median age was 64.5 years (range 24 to 84 years). Hematologic and gastroenterologic evaluations revealed no other potential cause of bleeding. Each patient had a diaphragmatic hernia. The median time between the diagnosis of anemia and surgical repair was 36 months (range 1 to 334 months). Forty-five patients (91.8%) had received replacement therapy, including iron for 43 and blood transfusions for 32 (median 6 units; range 2 to 70 units). Forty-six patients (93.9%) had symptoms: heartburn in 28, early satiety with bloating in 19, regurgitation in 11, dysphagia in 7, and aspiration in 4. Preoperative upper gastrointestinal endoscopic evaluation demonstrated gastric erosions at the level of the hiatus in 22 patients (44.9%), esophagitis in 7, stenosis in 1, and Barrett's disease in 1. An uncut Collis-Nissen fundoplication was performed in 44 patients, Belsey fundoplication in 2, a cut Collis-Nissen fundoplication, Nissen fundoplication, and Hill repair in 1 each. There was one operative death (2% mortality). Complications occurred in 18 patients (36.7%). Follow-up was complete and ranged from 4 to 103 months (median 63 months). Forty-five patients (91.8%) had resolution of their anemia. Functional results were excellent in 40 patients (81.6%), good in 2 (4.1%), fair in 4 (8.2%), and poor in 3 (6.1%). In most patients with diaphragmatic hernia and associated anemia refractory to medical treatment, surgical repair can result in successful resolution of the anemia. (J THORACCARDIOVASCSURG1996;112:1340-5)

This article has been cited by other articles:

				P. S. Dahlberg, C. Deschamps, D. L. Miller, M. S. Allen, F. C. Nichols, and P. C. Pairolero Laparoscopic repair of large paraesophageal hiatal hernia Ann. Thorac. Surg., October 1, 2001; 72(4): 1125 - 1129. [Abstract] [Full Text] [PDF]

				L. Kotsis The choice of fundoplication for mixed hiatal hernia and associated anemia J. Thorac. Cardiovasc. Surg., January 1, 1998; 115(1): 263 - 263. [Full Text]