P73 CONTRIBUTION TO THE IMPROVEMENT OF CARDIAC LOAD BY RADICAL SURGERY FOR ADVANCED ESOPHAGEAL HIATAL HERNIA

Abstract Aim The aim of this study is to clarify whether radical surgery for advanced esophageal hiatal hernia contribute to the improvement of cardiac load. Background & Methods In Japan, endoscopic surgery for esophageal hiatal hernia is increasing. In many cases, patients with mixed type hernia have the main symptom of meal passage disorder due to gastric torsion. On the other hand, there are cases in which the contents of hernia squeeze the heart and lung and the symptoms of respiratory and circulatory system get worse. And there are cases where cardiac load is exacerbated and QOL is got worse. Therefore, in addition to conventional surgical adaptation criteria such as vomiting and food loss, cardiac load aggravation may be added to the new surgical adaptation criteria. In this study, we measured BNP before and after surgery in the case of mixed type hiatal hernia who underwent surgery at our hospital, and examined changes in cardiac load. Our surgical procedure of laparoscopic fundoplication is basically toupet fundplication. In the elderly patients, the formation of toupet fundplication is about half a cycle, which is slightly looser than usual, in order to avoid passage obstruction of the wrap. If the esophageal hiatus is too large and it is difficult to suture closure, try to reduce the air pressure of laparoscopic surgery as much as possible to reduce the resistance to the suture closure. And we try not to damage the diaphragm leg. Results We experienced 70 esophageal hiatal hernia surgeries in 2012-2018 and 45 patient had mixed type hiatal hernia. In mixed type hiatal hernia case, 18 cases (40.0%) had chest symptoms such as fatigue and dyspnea on exertion. And there were 12 cases in which BNP could be measured before and after surgery as an evaluation for the presence of cardiac load. Postoperative BNP decreased in 11 of 12 cases from preoperative values. Almost all cases chest symptoms improved. In the above 45 cases, there have been no cases of reoperation and very few cases have taken proton pump inhibitors after surgery. Conclusion Surgical cases of giant hiatal hernia may increase in the future, especially in the elderly. Surgery for giant hiatal hernia can contribute to the improvement of cardiac load.

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Low-dose combined spinal-epidural anesthesia for a patient with a giant hiatal hernia who underwent urological surgery

Journal of International Medical Research ◽

10.1177/0300060518793800 ◽

2018 ◽

Vol 46 (10) ◽

pp. 4354-4359 ◽

Cited By ~ 1

Author(s):

Mi Kyeong Kim ◽

Junoik Shin ◽

Jeong-Hyun Choi ◽

Hee Yong Kang

Keyword(s):

Hiatal Hernia ◽

Epidural Catheter ◽

Epidural Anesthesia ◽

Low Dose ◽

Intrathecal Injection ◽

Vital Signs ◽

Esophageal Hiatus ◽

Urological Surgery ◽

Gastrointestinal Problems ◽

Giant Hiatal Hernia

A hiatal hernia refers to herniation of the abdominal organs through the esophageal hiatus of the diaphragm. A giant hiatal hernia affects digestive and cardiopulmonary function by compressing the organs. We report a patient who had low-dose combined spinal and epidural anesthesia (CSEA) for safe and effective anesthesia for conservative treatment of a giant hiatal hernia. An 84-year-old woman who had a giant hiatal hernia was scheduled for ureteroscopic removal of a ureteral stone. CSEA was performed at the L4 to L5 lumbar interspace and an epidural catheter tip was placed 5 cm cephalad from the inserted level. The T12 block was checked after 10 minutes of intrathecal injection of 6 mg of 0.5% bupivacaine. The T10 block was checked after additional injection of 80 mg of 2% lidocaine through the epidural catheter. During anesthesia and surgery, the patient's vital signs remained stable and the operation was completed within 1 hour without any problems. In conclusion, low-dose CSEA may be safely used without any cardiopulmonary and gastrointestinal problems in patients with a giant hiatal hernia undergoing urological surgery.

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Resorbable Synthetic Mesh Supported With Omentum Flap in the Treatment of Giant Hiatal Hernia

International Surgery ◽

10.9738/intsurg-d-13-00104.1 ◽

2014 ◽

Vol 99 (5) ◽

pp. 551-555

Author(s):

F. J. Pérez Lara ◽

R. Marín ◽

A. del Rey ◽

H. Oliva

Keyword(s):

Hiatal Hernia ◽

Synthetic Mesh ◽

Omental Flap ◽

Esophageal Hiatus ◽

Complication Rates ◽

Esophageal Erosion ◽

Basic Procedure ◽

Giant Hiatal Hernia ◽

Omentum Flap

Abstract Covering a large hiatal hernia with a mesh has become a basic procedure in the last few years. However, mesh implants are associated with high complication rates (esophageal erosion, perforation, fistula, etc.). We propose using a synthetic resorbable mesh supported with an omental flap as a possible solution to this problem. A 54-year-old female patient with a large hiatal defect (9 cm) was laparoscopically implanted with a synthetic resorbable mesh supported with an omental flap. The surgical procedure was successful and the patient was discharged on postoperative day 2. On a follow-up examination 6 months after surgery, she remained free of relapse or complication signs. Supporting an implanted resorbable mesh with an omental flap may be a solution to the problems posed by large esophageal hiatus defects. However, more studies based on larger patient samples and longer follow-up periods are necessary.

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A CASE OF ESOPHAGEAL HIATAL HERNIA OF LARGE MIXED TYPE SUCCESSFULLY TREATED WITH A LAPAROSCOPIC NISSEN'S FUNDOPLICATION

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.68.2486 ◽

2007 ◽

Vol 68 (10) ◽

pp. 2486-2489 ◽

Cited By ~ 1

Author(s):

Satoshi SUGITA ◽

Atsushi SASAKI ◽

Norio SHIRAISHI ◽

Seigo KITANO

Keyword(s):

Hiatal Hernia ◽

Mixed Type ◽

Esophageal Hiatal Hernia

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Paraesophageal Hernia as a Cause of Chronic Asymptomatic Anemia in a 6 Years Old Boy; Case Report and Review of the Literature

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2017.97 ◽

2017 ◽

Vol 60 (2) ◽

pp. 76-81

Author(s):

Dimitrios Patoulias ◽

Maria Kalogirou ◽

Thomas Feidantsis ◽

Ignatios Kallergis ◽

Ioannis Patoulias

Keyword(s):

Hiatal Hernia ◽

Paraesophageal Hernia ◽

Esophageal Hiatus ◽

Type Ii ◽

Hernia Sac ◽

Esophageal Hiatal Hernia ◽

Type Iv ◽

Abdominal Organs ◽

Total Fundoplication ◽

Sliding Hiatal Hernia

Esophageal hiatal hernia is defined as the prolapse of one or more intra-abdominal organs through the esophageal hiatus. Four types are identified: type Ι or sliding hiatal hernia, type II or paraesophageal hernia (PEH), type III or mixed hernia and type IV. Congenital type II esophageal hiatal hernia is caused by a remaining gap after the formation of pleuroperitoneal membrane. We present a case of a six years old boy admitted to our department, appearing with asymptomatic anemia, who was incidentally diagnosed with Type II esophageal hiatal hernia. After diagnostic investigation, the prolapsing stomach pouch was reduced, the hernia sac was excised, the crura of diaphragm were converged and a total fundoplication was performed, via open method. The patient had an uncomplicated postoperative period. We conclude that: 1) esophageal hiatal hernia should be included within diagnostic approach of a child with chronic non-hereditary anemia, 2) after a Type II esophageal hiatal hernia is diagnosed, a hernia repair surgery is indicated in short time, due to the severity of possible complications and 3) through the performance of total fundoplication, it is secured that the subdiaphragmatic abdominal part of esophagus will be retained, preventing the development of post-operative gastroesophageal reflux disease.

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SURGICAL TACTICS FOR LARGE AND GIANT ESOPHAGEAL HIATAL HERNIA

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2018-177-4-63-66 ◽

2018 ◽

Vol 177 (4) ◽

pp. 63-66 ◽

Cited By ~ 1

Author(s):

D. M. Cherkasov ◽

M. F. Cherkasov ◽

V. K. Tat’yanchenko ◽

Yu. M. Starcev ◽

S. G. Melikova ◽

...

Keyword(s):

Surgical Treatment ◽

Hiatal Hernia ◽

Postoperative Period ◽

Posterior Mediastinum ◽

Esophageal Hiatus ◽

Intraoperative Bleeding ◽

Esophageal Hiatal Hernia ◽

Surgical Tactics ◽

Mesh Implant

The OBJECTIVE is to improve the results of surgical treatment of patients with large and giant EHH. MATERIAL AND METHODS. We present our experience of surgical treatment of 25 patients with large and giant EHH, who underwent laparoscopic interventions according to the original technique, which consisted in the method of plasty of esophageal hiatus: the mesh implant was installed and fixed in the posterior mediastinum above the diaphragm. RESULTS. Intraoperative bleeding was noted in 2 (8 %) patients, which did not require conversion. In the near postoperative period, no complications were noted. In the long-term periods from 1 to 5 years, there was no recurrence of EHH and complications associated with the use of mesh implant. CONCLUSION. Videoendosurgical interventions are the operations of choice in the treatment of patients with large and giant EHH. The most effective method of plasty for large and giant EHH is the combined plasty of the esophageal hiatus by a mesh implant in combination with a posterior cruroraphy, with the installation and fixation of the mesh implant in the posterior mediastinum above the cruses of diaphragm.

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PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

Surya Medika: Jurnal Ilmiah Ilmu Keperawatan dan Ilmu Kesehatan Masyarakat ◽

10.32504/sm.v13i1.99 ◽

2019 ◽

Vol 13 (1) ◽

Author(s):

Niken Setyaningrum ◽

Andri Setyorini ◽

Fachruddin Tri Fitrianta

Keyword(s):

Blood Pressure ◽

Data Analysis ◽

The Elderly ◽

Control Group ◽

Group Comparison ◽

Control Blood Pressure ◽

Men And Women ◽

Treatment Of Hypertension ◽

Before And After ◽

The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

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Intergenerational Education for the Psychological, Social and Educational Improvement of the Elderly

10.35262/jiag.v15i1.22-26 ◽

2019 ◽

Vol 15 (1) ◽

pp. 22-26

Author(s):

Nazaret Martínez-Heredia

Keyword(s):

Educational Level ◽

Mixed Type ◽

Healthy Aging ◽

Social Role ◽

Intergenerational Relationships ◽

Daily Practice ◽

The Elderly ◽

Educational Improvement ◽

Intergenerational Education

Introduction: Intergenerational education encourages cooperation and interaction between two or more generations through experiences, knowledge, skills, attitudes and values. Objective: The main objective of our research was to know the benefits at the psychological, social and educational level of intergenerational education. Methods: This is mixed-type research establishing relationships between young and old. The sample consists of a total of 94 people, 47 young people (aged between 21 and 40 years old) and 47 older (aged between 65 and 85 years). We promote the development of a mixed methodology to know if after the implementation of an intergenerational program we have obtained benefits in the elderly participants. Results: Considering the results we can say that the benefits at the psychological, social and educational level have been very remarkable of our elders. Conclusions: We must bet on intergenerational relationships as an ideal within our daily practice achieving a healthy aging, benefiting continuity in an active social role of our elders.

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