Medical complications affecting the heart, lungs and kidneys are often associated with PEH repair because the operation is mostly performed for elderly patients with co-morbidities. The list of complications reported after PEH repair is long.
Due to the complexity of the operation, a significant learning curve is necessary for a surgeon to reduce complications rate to those of experts ( 3- 5). Laparoscopic paraesophageal hernia (PEH) repair can be done safely in expert hands with mortality rates of 1.3% in elective settings and 8% in emergencies ( 1, 2). Received: 19 November 2019 Accepted: 12 June 2020 Published: 20 October 2021.
Keywords: Paraesophageal hernia (PEH) laparoscopic repair complications minimally invasive surgery Longer term revisional surgery for life-threatening or life-impairing complications can be done safely by expert surgeons but has a lower chance of success than primary surgery. Other complications that can severely impair quality of life in the longer term include esophago-gastric junction stenosis, hiatus hernia recurrence, delayed gastric emptying and excess intestinal gas. Some life-threatening complications such as acute gastric dilatation, aortic fistula, gastric necrosis and perforation can occur months, and even years, after the procedure. Asymptomatic hiatus hernia recurrence does not require surgery, but symptomatic and complicated hernias can be re-repaired. Early acute dysphagia warrants a return to theatre for correction while delayed dysphagia can in some patients be treated by dilatation. Intra-operative perforation of the esophagus or stomach is best avoided, but it can be successfully repaired. Hemodynamic instability from cardiovascular injury or bleeding mandates an early return to theatre. Capnothorax and pneumothorax should be dealt with immediately by lowering insufflation pressure, aspiration and drain placement. Careful intra-operative correctional techniques and prompt return to theatre for early post-operative complications result in a satisfactory outcome. However, it is a complex operation carrying significant risk of peri-operative morbidity and mortality. Policy of Dealing with Allegations of Research MisconductĪbstract: Laparoscopic paraesophageal hernia (PEH) repair can be performed safely in expert hands.Policy of Screening for Plagiarism Process.
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