Abstract：
OBJECTIVE: As Japanese society ages, the number of surgeries performed in elderly patients with hiatal hernia (HH) is increasing. In this study, we examined the feasibility, safety, and potential effectiveness of the addition of anterior gastropexy to hiatoplasty with or without mesh repair and/or fundoplication in elderly Japanese HH patients.
METHODS: We retrospectively evaluated 39 patients who underwent laparoscopic HH repair between 2010 and 2021. We divided them into 2 groups according to age: the \"younger\" group (< 75 years old, n = 21), and the \"older\" group (≥ 75 years old, n = 18). The patient characteristics, intraoperative data, and postoperative results were collected.
RESULTS: The median ages were 68 and 82 years old in the younger and older groups, respectively, and the female ratio was similar between the groups (younger vs. older: 67% vs. 78%, p = 0.44). The older group had more type III/IV HH cases than the younger group (19% vs. 83%, p < 0.001). The operation time was longer in the older group than in the younger group, but there was no significant difference in blood loss, perioperative complications, or postoperative length of stay between the groups. The older group had significantly more cases of anterior gastropexy (0% vs. 78%, p < 0.001) and less fundoplication (100% vs. 67%, p = 0.004) than the younger group. There was no significant difference in HH recurrence between the groups (5% vs. 11%, p = 0.46).
CONCLUSIONS: The addition of anterior gastropexy to other procedures is feasible, safe, and potentially effective in elderly Japanese patients with HH.
METHODS: We retrospectively evaluated 39 patients who underwent laparoscopic HH repair between 2010 and 2021. We divided them into 2 groups according to age: the \"younger\" group (< 75 years old, n = 21), and the \"older\" group (≥ 75 years old, n = 18). The patient characteristics, intraoperative data, and postoperative results were collected.
RESULTS: The median ages were 68 and 82 years old in the younger and older groups, respectively, and the female ratio was similar between the groups (younger vs. older: 67% vs. 78%, p = 0.44). The older group had more type III/IV HH cases than the younger group (19% vs. 83%, p < 0.001). The operation time was longer in the older group than in the younger group, but there was no significant difference in blood loss, perioperative complications, or postoperative length of stay between the groups. The older group had significantly more cases of anterior gastropexy (0% vs. 78%, p < 0.001) and less fundoplication (100% vs. 67%, p = 0.004) than the younger group. There was no significant difference in HH recurrence between the groups (5% vs. 11%, p = 0.46).
CONCLUSIONS: The addition of anterior gastropexy to other procedures is feasible, safe, and potentially effective in elderly Japanese patients with HH.
摘要：
目标：随着日本社会的老龄化，老年食管裂孔疝(HH)患者的手术数量正在增加.在这项研究中,我们检查了可行性，安全,在老年日本HH患者中，在有或没有网状修复和/或胃底折叠术的情况下，在组织成形术中增加前胃切除术的潜在有效性。
方法：我们回顾性评估了2010年至2021年间接受腹腔镜HH修复的39例患者。我们根据年龄将他们分为两组：“年轻”组（<75岁，n=21),和“老年”组(≥75岁，n=18)。病人的特点,术中数据,收集术后结果。
结果：年轻和老年组的平均年龄分别为68和82岁，分别,两组之间的女性比例相似(年轻vs.年龄：67%vs.78%,p=0.44）。老年组比年轻组有更多的III/IV型HH病例(19%vs.83%,p<0.001)。老年组手术时间长于年轻组，但在失血方面没有显著差异,围手术期并发症,或术后住院时间。老年组的前胃切除术病例明显增多(0%vs.78%,p<0.001)和较少的胃底折叠(100%vs.67%,p=0.004）比年轻组。两组之间的HH复发没有显着差异（5％vs.11%,p=0.46）。
结论：在其他手术中增加前胃切除术是可行的，安全,对日本老年HH患者可能有效。
方法：我们回顾性评估了2010年至2021年间接受腹腔镜HH修复的39例患者。我们根据年龄将他们分为两组：“年轻”组（<75岁，n=21),和“老年”组(≥75岁，n=18)。病人的特点,术中数据,收集术后结果。
结果：年轻和老年组的平均年龄分别为68和82岁，分别,两组之间的女性比例相似(年轻vs.年龄：67%vs.78%,p=0.44）。老年组比年轻组有更多的III/IV型HH病例(19%vs.83%,p<0.001)。老年组手术时间长于年轻组，但在失血方面没有显著差异,围手术期并发症,或术后住院时间。老年组的前胃切除术病例明显增多(0%vs.78%,p<0.001)和较少的胃底折叠(100%vs.67%,p=0.004）比年轻组。两组之间的HH复发没有显着差异（5％vs.11%,p=0.46）。
结论：在其他手术中增加前胃切除术是可行的，安全,对日本老年HH患者可能有效。
