ABSTRACT
To verify the results of the treatment of post-operative giant hiatal hernia (POGH).The POGH becomes each time more frequent after surgical treatment of the gastroesophageal reflux.Fifteen patients (6 females and 9 males; 43.66â±â5.05 years old; BMI 22.13â±â1.92) were referred to our Service, for surgical treatment of a type III POGH 30.4â±â1.76 months after treatment of gastroesophageal reflux disease. The need for a reoperation was determined mainly by dysphagia.Reoperation was completed laparoscopically in all patients and the mean postoperative hospital stay was 3.2â±â1.2 days (range, 1-6 days). Mortality was 0% and there were not postoperative complications. They became asymptomatic along follow-up of 2.86â±â1.40 years. Around 1 year from the procedure, patients were submitted to control exams and barium esophagogram revealed well positioned esophago-gastric junction and signs of intact fundoplicature, the same observation having been done at esophageal endoscopy. Esophageal manometry showed preserved peristaltism, increase of resting pressure and extension of the intra-abdominal LES and significant raise of amplitude of deglutition waves at distal third of the esophagus. No reflux was observed at post-operative 24-hour pH testing.The corrective surgery of POGH can often be completed laparoscopically in experienced hands. Successful results can be obtained performing reduction of the hernia, sac excision, crural repair, anti-reflux procedure and long anterior gastropexy.
