Prevalence and Resolution of Anemia with Paraesophageal Hernia Repair

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2012 Jul 31

PMID 22843082

Citations 8

Authors

Chady Haurani

Arthur M Carlin

Zane T Hammoud

Vic Velanovich

Affiliations

Soon will be listed here.

Abstract

Background: Paraesophageal hernias may produce a variety of clinical sequelae including anemia and esophagogastric ulcerations or erosions. We examined the prevalence of anemia in patients with paraesophageal hernias and frequency of anemia resolution with hernia repair.

Methods: Patients undergoing paraesophageal hernia repairs from July 1996 to September 2010 were included. Data gathered included age, gender, type of hernia, presence of symptomatic anemia, presence of esophagogastric ulcer/erosion, type of repair, and anemia resolution.

Results: One hundred eighty-three patients underwent paraesophageal hernia repair; of these, 68 (37%) were anemic. Of these anemic patients, 39 (57%) were symptomatic from their anemia or specifically referred for anemia, and 20 (29%) had esophagogastric ulceration/erosion. Fifty-eight had documented follow-up. Overall, of these, 35 (60%) had resolution of their anemia. Seventy percent of symptomatic patients had resolution of their anemia, compared to 48% of asymptomatic patients (p = 0.1). Of patients with esophagogastric ulceration/erosion, 85% were symptomatic and 88% had resolution of anemia, compared to 50% of patients without ulceration/erosion (p = 0.015).

Conclusions: Anemia was a common finding in patients with paraesophageal hernia and most patients were symptomatic because of their anemia. Those patients with esophageal or gastric ulceration/erosion were very likely to have symptomatic anemia, and, interestingly, these patients were more likely to have their anemia resolve with paraesophageal hernia repair.

Citing Articles

Laparoscopic hiatal hernia repair for treating patients with massive hiatal hernia and iron-deficiency anaemia.

Aili A, Maimaitiming M, Li Y, Maisiyiti A, Wang Z, Tusuntuoheti Y BMC Surg. 2023; 23(1):293.

PMID: 37752453 PMC: 10521551. DOI: 10.1186/s12893-023-02184-3.

Surgical treatment of anaemia - is it possible? Large hiatal hernia as a cause of severe iron-deficiency anaemia.

Feret W, Nalewajska M, Ciechanowski K Prz Gastroenterol. 2022; 17(3):248-249.

PMID: 36127937 PMC: 9475483. DOI: 10.5114/pg.2022.118453.

Paraesophageal hernia repair: a curative consideration for chronic anemia?.

Cheverie J, Lam J, Neki K, Broderick R, Lee A, Matsuzaki T Surg Endosc. 2019; 34(5):2243-2247.

PMID: 31346751 DOI: 10.1007/s00464-019-07014-3.

Preoperative anemia: a common finding that predicts worse outcomes in patients undergoing primary hiatal hernia repair.

Chevrollier G, Brown A, Keith S, Szewczyk J, Pucci M, Chojnacki K Surg Endosc. 2018; 33(2):535-542.

PMID: 29998393 DOI: 10.1007/s00464-018-6328-4.

The impact of preoperative anemia and malnutrition on outcomes in paraesophageal hernia repair.

Clark L, Helm M, Higgins R, Lak K, Kastenmeier A, Kindel T Surg Endosc. 2018; 32(11):4666-4672.

PMID: 29934871 DOI: 10.1007/s00464-018-6311-0.

References

Panzuto F, Di Giulio E, Capurso G, Baccini F, DAmbra G, Fave G . Large hiatal hernia in patients with iron deficiency anaemia: a prospective study on prevalence and treatment. Aliment Pharmacol Ther. 2004; 19(6):663-70. DOI: 10.1111/j.1365-2036.2004.01894.x. View

SKINNER D, Belsey R . Surgical management of esophageal reflux and hiatus hernia. Long-term results with 1,030 patients. J Thorac Cardiovasc Surg. 1967; 53(1):33-54. View

Raju G, Gerson L, Das A, Lewis B . American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology. 2007; 133(5):1694-6. DOI: 10.1053/j.gastro.2007.06.008. View

Cameron A, Higgins J . Linear gastric erosion. A lesion associated with large diaphragmatic hernia and chronic blood loss anemia. Gastroenterology. 1986; 91(2):338-42. View

Stylopoulos N, Gazelle G, Rattner D . Paraesophageal hernias: operation or observation?. Ann Surg. 2002; 236(4):492-500; discussion 500-1. PMC: 1422604. DOI: 10.1097/00000658-200210000-00012. View

Trastek V, Allen M, Deschamps C, Pairolero P, Thompson A . Diaphragmatic hernia and associated anemia: response to surgical treatment. J Thorac Cardiovasc Surg. 1996; 112(5):1340-4; discussion 1344-5. DOI: 10.1016/S0022-5223(96)70149-6. View

Schieman C, Grondin S . Paraesophageal hernia: clinical presentation, evaluation, and management controversies. Thorac Surg Clin. 2010; 19(4):473-84. DOI: 10.1016/j.thorsurg.2009.08.006. View

Maganty K, Smith R . Cameron lesions: unusual cause of gastrointestinal bleeding and anemia. Digestion. 2008; 77(3-4):214-7. DOI: 10.1159/000144281. View

ANDUJAR J, Papasavas P, Birdas T, Robke J, Raftopoulos Y, Gagne D . Laparoscopic repair of large paraesophageal hernia is associated with a low incidence of recurrence and reoperation. Surg Endosc. 2004; 18(3):444-7. DOI: 10.1007/s00464-003-8823-4. View

10.

Velanovich V, Karmy-Jones R . Surgical management of paraesophageal hernias: outcome and quality of life analysis. Dig Surg. 2002; 18(6):432-7; discussion 437-8. DOI: 10.1159/000050189. View

11.

Pierre A, Luketich J, Fernando H, Christie N, Buenaventura P, Litle V . Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients. Ann Thorac Surg. 2003; 74(6):1909-15; discussion 1915-6. DOI: 10.1016/s0003-4975(02)04088-2. View

12.

Hayden J, Jamieson G . Effect on iron deficiency anemia of laparoscopic repair of large paraesophageal hernias. Dis Esophagus. 2005; 18(5):329-31. DOI: 10.1111/j.1442-2050.2005.00508.x. View

13.

Patel H, Tan B, Yee J, Orringer M, Iannettoni M . A 25-year experience with open primary transthoracic repair of paraesophageal hiatal hernia. J Thorac Cardiovasc Surg. 2004; 127(3):843-9. DOI: 10.1016/j.jtcvs.2003.10.054. View

14.

Moskovitz M, Fadden R, Min T, Jansma D, Gavaler J . Large hiatal hernias, anemia, and linear gastric erosion: studies of etiology and medical therapy. Am J Gastroenterol. 1992; 87(5):622-6. View

15.

Hill L . Incarcerated paraesophageal hernia. A surgical emergency. Am J Surg. 1973; 126(2):286-91. DOI: 10.1016/s0002-9610(73)80165-5. View

16.

WINDSOR C, COLLIS J . Anaemia and hiatus hernia: experience in 450 patients. Thorax. 1967; 22(1):73-8. PMC: 471591. DOI: 10.1136/thx.22.1.73. View