Controversies regarding the management of hiatus hernia

Ellis, F. Henry

doi:10.1016/0002-9610(80)90383-9

Cited by 17 publications

(36 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Much of the information in the human literature is based on experiments in animals (mostly dogs) and reported surgical complications in humans and dogs are identical. 5,[15][16][17] Contrary to previous reports, 2,5 a primary disturbance of the intrinsic LOS has not been demonstrated in humans (or dogs), but rather the axial separation of the hiatus from the intrinsic LOS is detrimental to its function. 18 Whilst information from the human literature should not be applied indiscriminately to other species, there is little or no evidence to support a difference in pathophysiology.…”

contrasting

confidence: 54%

“…35 Obesity and pregnancy in humans increase intra-abdominal pressure and may worsen a HH. 5 Although most cases of HH are isolated, familial inheritance of HH has been shown in humans, with evidence pointing to an autosomal dominant mode of inheritance. 36 Familial inheritance has not been shown in animals but Shar-pei dogs do have a breed predisposition for the condition.…”

Section: Displacement Of the Oesophagogastric Junction And Gastrooesmentioning

confidence: 98%

“…9 The majority of clinical signs associated with sliding HH in dogs and humans are those related to a reflux oesophagitis. 3,5,9,14 Reflux of gastric acid into the distal end of the oesophagus occurs infrequently in normal dogs. 20 Severe disruption of the anatomy around the oesophagogastric junction that occurs with HH may increase gastro-oesophageal reflux.…”

Section: Displacement Of the Oesophagogastric Junction And Gastrooesmentioning

confidence: 99%

“…Aust Vet J 2002;80:48-53 HH Liatal hernia LOS (intrinsic) lower oesophageal sphincter H iatal hernia is uncommon in dogs and cats 1,2,3 although it is well recognised in humans. 4,5 The underlying aetiology and pathophysiology are incompletely understood, and even terminology of the types of HH has been unclear. 6,7,8 Whilst progress is being made in our understanding, 1,2,9-12 there has been no detailed discussion of pathophysiology in the veterinary literature.…”

mentioning

confidence: 99%

“…4,5 The underlying aetiology and pathophysiology are incompletely understood, and even terminology of the types of HH has been unclear. 6,7,8 Whilst progress is being made in our understanding, 1,2,[9][10][11][12] there has been no detailed discussion of pathophysiology in the veterinary literature.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Hiatal hernia controversies ‐ a review of pathophysiology and treatment options

Sivacolundhu¹,

Read

Marchevsky³

2002

Aust Veterinary J

View full text Add to dashboard Cite

Hiatal hernia is not completely understood in humans or animals. It has a complex multifactorial aetiology and pathophysiology. A primary disturbance of the lower oesophageal sphincter has not been shown in humans or animals. Knowledge of pathophysiology is necessary to institute appropriate treatment. Medical and/or surgical therapy is not indicated in asymptomatic cases. Medical treatment should be used for up to 1 month in stable cases of sliding hiatal hernia. Paraoesophageal hiatal hernias and any large sliding hiatal hernia should be considered for prompt surgical treatment. Surgical techniques used depend on the type of hiatal hernia present. Surgical treatment of hiatal hernia cases should be performed by experienced surgeons, and must include hiatal closure and gastropexy. The Nissen fundoplication procedure has been discontinued in the veterinary field due to poor success rates, coupled with the published view that there is a marked difference in pathophysiology between humans and dogs. Reported complications associated with the original Nissen fundoplication technique are identical in the human and veterinary literature. There have been no complications reported with use of the modified or 'floppy' Nissen fundoplication in dogs. Both oesophagopexy and Nissen fundoplication require further evaluation in small animals.

show abstract

contrasting

confidence: 54%

Section: Displacement Of the Oesophagogastric Junction And Gastrooesmentioning

confidence: 98%

Section: Displacement Of the Oesophagogastric Junction And Gastrooesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Hiatal hernia controversies ‐ a review of pathophysiology and treatment options

Sivacolundhu¹,

Read

Marchevsky³

2002

Aust Veterinary J

View full text Add to dashboard Cite

show abstract

Mesh in the Hiatus

Targarona¹

2004

Arch Surg

109

View full text Add to dashboard Cite

To analyze the experience acquired to date on the use of prosthetic mesh to prevent recurrence after laparoscopic repair of paraesophageal hernia. Data Sources: Current English-language literature review. Study Selection: Case reports, series, and opinion articles on the use of mesh for paraesophageal hernia repair. Data Extraction and Synthesis: Study type and results were analyzed. Most articles were short case series. Few comparative or randomized trials assessing the procedure have been published to date. The information available showed that the use of a mesh for hiatal repair was safe and prevented recurrence. However, data on the longterm results were lacking, and infrequent but severe complications may arise. Conclusions: The mesh should be used selectively, and the decision to proceed should be based on clinical experience. In light of the evidence available, however, it appears to be safe, and the fears expressed in the past have not been confirmed.

show abstract

Prospective study of the Angelchik anti-reflux prosthesis

Wale

Royston

Bennett

et al. 1985

Journal of British Surgery

View full text Add to dashboard Cite

Fifty patients with medically refractory gastro-oesophageal reflux were treated by the insertion of an Angelchik anti-reflux prosthesis. All patients had a pre-operative upper gastrointestinal endoscopy, 32 were investigated with 15 h overnight oesophageal pH studies combined with oesophageal bile sampling and 20 underwent oesophageal manometric studies. At pre-operative endoscopy 45 patients had evidence of oesophagitis and the 5 who did not had pathological reflux demonstrated on overnight pH testing. Postoperatively the main clinical problem was dysphagia which appeared to settle with time but left one-third of patients with mild dysphagia at the end of 12 months. A further 12 per cent had residual moderate to severe dysphagia which required the removal of the prosthesis in five patients (10 per cent). In only one patient was the dysphagia due to prosthetic migration and this was the first patient in the series. Subsequently, we have had no problems with prosthetic migration, disruption, or erosion into the oesophagus. The overnight pH studies confirmed the efficacy of the prosthesis in preventing reflux which correlated with symptomatic improvement. We conclude that, while the Angelchik anti-reflux prosthesis is an effective device, it has a disturbingly high incidence of postoperative dysphagia though this appears to settle with time, leaving around 10 per cent of patients with severe dysphagia which will necessitate removal of the prosthesis and one-third with mild dysphagia which may settle with the further passage of time.

show abstract

Controversies regarding the management of hiatus hernia

Cited by 17 publications

References 26 publications

Hiatal hernia controversies ‐ a review of pathophysiology and treatment options

Hiatal hernia controversies ‐ a review of pathophysiology and treatment options

Mesh in the Hiatus

Prospective study of the Angelchik anti-reflux prosthesis

Contact Info

Product

Resources

About