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The role of anterior gastropexy in elderly Japanese hiatal hernia patients

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Abstract

Purpose

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.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, Japan

    Takashi Yokouchi, Kiyokazu Nakajima, Tsuyoshi Takahashi, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Kazuyoshi Yamamoto, Tomoki Makino, Yukinori Kurokawa, Hidetoshi Eguchi & Yuichiro Doki

  2. Department of Next Generation Endoscopic Intervention (Project ENGINE), Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, Japan

    Takashi Yokouchi & Kiyokazu Nakajima

Authors
  1. Takashi Yokouchi
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  2. Kiyokazu Nakajima
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  3. Tsuyoshi Takahashi
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  4. Kotaro Yamashita
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  5. Takuro Saito
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  6. Koji Tanaka
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  7. Kazuyoshi Yamamoto
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  8. Tomoki Makino
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  9. Yukinori Kurokawa
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  10. Hidetoshi Eguchi
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  11. Yuichiro Doki
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Contributions

All authors contributed significantly to this study and have read and approved the content of the manuscript.

Corresponding author

Correspondence to Kiyokazu Nakajima.

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Conflict of interest

We have no conflicts of interest to declare in association with this study.

Ethical approval

This study was reviewed and approved by the Ethics Committee of Osaka University (approval number. 23112), and informed consent was obtained from all patients.

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Yokouchi, T., Nakajima, K., Takahashi, T. et al. The role of anterior gastropexy in elderly Japanese hiatal hernia patients. Surg Today (2024). https://doi.org/10.1007/s00595-024-02809-x

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  • DOI: https://doi.org/10.1007/s00595-024-02809-x

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