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Yang H, Yuan X, Nie Y, Guan L, Chen J. The laparoscopic repair of giant diaphragmatic hernia with synthetic mesh: A report of three cases. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2021. [DOI: 10.4103/ijawhs.ijawhs_37_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Perrone G, Giuffrida M, Annicchiarico A, Bonati E, Del Rio P, Testini M, Catena F. Complicated Diaphragmatic Hernia in Emergency Surgery: Systematic Review of the Literature. World J Surg 2020; 44:4012-4031. [DOI: 10.1007/s00268-020-05733-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2020] [Indexed: 12/18/2022]
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Ceccarelli G, Pasculli A, Bugiantella W, De Rosa M, Catena F, Rondelli F, Costa G, Rocca A, Longaroni M, Testini M. Minimally invasive laparoscopic and robot-assisted emergency treatment of strangulated giant hiatal hernias: report of five cases and literature review. World J Emerg Surg 2020; 15:37. [PMID: 32487136 PMCID: PMC7268602 DOI: 10.1186/s13017-020-00316-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Background Giant hiatal hernia (GHH) is a condition where one-third of the stomach migrates into the thorax. Nowadays, laparoscopic treatment gives excellent postoperative outcomes. Strangulated GHH is rare, and its emergent repair is associated with significant morbidity and mortality rates. We report a series of five cases of strangulated GHH treated by a minimally invasive laparoscopic and robot-assisted approach, together with a systematic review of the literature. Methods During 10 years (December 2009–December 2019), 31 patients affected by GHH were treated by robot-assisted or conventional laparoscopic surgical approach. Among them, five cases were treated in an emergency setting. We performed a PubMed MEDLINE search about the minimally invasive emergent treatment of GHH, selecting 18 articles for review. Results The five cases were male patients with a mean age of 70 ± 18 years. All patients referred to the emergency service complaining of severe abdominal and thoracic pain, nausea and vomiting. CT scan and endoscopy were the main diagnostic tools. All patients showed stable hemodynamic conditions so that they could undergo a minimally invasive attempt. The surgical approach was robotic-assisted in three patients (60%) and laparoscopic in two (40%). Patients reported no complications or recurrences. Conclusion Reviewing current literature, no general recommendations are available about the emergent treatment of strangulated hiatal hernia. Acute mechanical outlet obstruction, ischemia of gastric wall or perforation and severe bleeding are the reasons for an emergent surgical indication. In stable conditions, a minimally invasive approach is often feasible. Moreover, the robot-assisted approach, allowing a stable 3D view and using articulated instruments, represents a reasonable option in challenging situations.
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Affiliation(s)
- Graziano Ceccarelli
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Alessandro Pasculli
- Unit of General Surgery "V. Bonomo", Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro", Polyclinic of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | - Walter Bugiantella
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Michele De Rosa
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Fausto Catena
- Department of Emergency and Trauma Surgery, Parma University Hospital, Viale Antonio Gramsci 11, 43126, Parma, Italy
| | - Fabio Rondelli
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Gianluca Costa
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Aldo Rocca
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via Francesco de Sanctis 1, 86100, Campobasso, Italy
| | - Mattia Longaroni
- General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via Massimo Arcamone 1, 06034, Foligno, Italy
| | - Mario Testini
- Unit of General Surgery "V. Bonomo", Department of Biomedical Sciences and Human Oncology, University of Bari "A. Moro", Polyclinic of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
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