Hiatal and paraesophageal hernia repair in pediatric patients

Abstract Hiatal and paraesophageal hernia (HH/PEH) can be congenital, resulting from embryologic abnormalities/genetic predisposition, or acquired, most commonly after gastro-esophageal surgery such as fundoplication. Minimizing circumferential esophageal dissection at the time of Nissen fundoplicat...

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Bibliographic Details
Published in:Seminars in pediatric surgery 2017-04, Vol.26 (2), p.61-66
Main Authors: Garvey, Erin M, MD, Ostlie, Daniel J, MD
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Hernia, Hiatal - surgery
Herniorrhaphy - methods
Hiatal hernia
Humans
Infant
Infant, Newborn
Laparoscopy - methods
Mesh
Paraesophageal hernia
Pediatric
Pediatrics
Recurrence
Surgery
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Summary:Abstract Hiatal and paraesophageal hernia (HH/PEH) can be congenital, resulting from embryologic abnormalities/genetic predisposition, or acquired, most commonly after gastro-esophageal surgery such as fundoplication. Minimizing circumferential esophageal dissection at the time of Nissen fundoplication has been shown to decrease the risk of acquired HH/PEH from 36.5 to 12.2%. Gastrointestinal, respiratory and constitutional symptoms, including anemia and failure to thrive, are common with high rates of associated gastroesophageal reflux. Chest x-ray is often abnormal and upper GI confirms the diagnosis. Treatment is surgical with the goal of reducing the hernia contents, excising the hernia sac, closing the crura and performing an antireflux procedure. The laparoscopic approach is safe and effective.
ISSN:1055-8586
1532-9453
DOI:10.1053/j.sempedsurg.2017.02.008