CONCOMITANT LAPAROSCOPIC HIATAL HERNIA REPAIR WITH CHOLECYSTECTOMY: A MULTICENTRIC STUDY

https://www.doi.org/10.22551/MSJ.2021.01.14

  • PREDA S. D. Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery
  • PREDA Agnesa
  • KONSTANTINOS S. Aristotle” University of Thessaloniki, Greece
  • ZAROGOULIDIS P. “Aristotle” University of Thessaloniki, Greece
  • BINTINTAN V. V. “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
  • CRISTIAN D. A. “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • BICA M. Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery
  • PATRASCU S. Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery
  • PANTEA S. “Victor Babeș” University of Medicine and Pharmacy of Timisoara, Romania
  • ROMANIDIS K. Medical School, Democritus University of Thrace, Alexandroupolis, Greece
  • PADUREANU V. University of Medicine and Pharmacy of Craiova, Romania
  • SURLIN M. V. Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery

Abstract

Concomitant surgery refers to performing two or more surgical operations on one patient under the same anesthesia. Material and methods: We performed a retrospective multicenter study from October 2016 to October 2019, analyzing patients who underwent laparoscopic hiatal hernia repair. We extracted data of patients who underwent concomitant laparoscopic surgery for both hiatal hernia repair and cholecystectomy in the following Clinics: 1st Clinic of Surgery of Craiova Emergency Clinical County Hospital, “Colțea” Hospital, 3rd Clinic of Surgery of Cluj-Napoca and 3rd Surgery Clinic of University General Hospital of Thessaloniki and identified 20 patients who underwent hiatal hernia repair and had an added cholecystectomy. Results: Allocation of data by hiatal hernia type showed 6 type IV hernia (complex hernia), 13 type III hernias (mixed type) and 1 type I hernia (sliding hernia). Out of the 20 cases analyzed; 19 were chronic cholecystitis and one patient presented with acute cholecystitis. Average operating time was 168 minutes. Blood loss was minimum.  Cruroraphy was performed in all cases, mesh reinforcement was added in 5 cases, and fundoplication was added in all cases: 3 Toupet, 2 Dorr and 15 Floppy-Nissen. Fundopexy was routinely added in cases with Toupet fundoplication. Cholecystectomy was performed in the following manner: 19 retrograde, 1 bipolar. All patients had favorable postoperative course. Patients follow up was at 1 month, 3 months and 6 months, with no signs of recurrence for hiatal hernia (anatomical or symptomatic) and no post cholecystectomy syndrome. Conclusions: Concomitant laparoscopic hiatal hernia repair and cholecystectomy is a safe and feasible option for patients with indication of surgery for both pathologies.

Author Biographies

PREDA S. D., Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery

University of Medicine and Pharmacy of Craiova, Romania

PREDA Agnesa

University of Medicine and Pharmacy of Craiova, Romania

KONSTANTINOS S., Aristotle” University of Thessaloniki, Greece

University General Hospital of Thessaloniki Greece / Third Surgery Clinic

ZAROGOULIDIS P., “Aristotle” University of Thessaloniki, Greece

University General Hospital of Thessaloniki Greece / Third Surgery Clinic

BINTINTAN V. V., “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania

First Clinic of Surgery of Cluj-Napoca, Romania

CRISTIAN D. A., “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

“Colțea” Clinical Hospital / Department of Surgery, Bucharest, Romania

BICA M., Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery

University of Medicine and Pharmacy of Craiova, Romania

PATRASCU S., Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery

University of Medicine and Pharmacy of Craiova, Romania

PANTEA S., “Victor Babeș” University of Medicine and Pharmacy of Timisoara, Romania

Third Clinic of Surgery, Timisoara, Romania

ROMANIDIS K., Medical School, Democritus University of Thrace, Alexandroupolis, Greece

University Hospital of Alexandroupolis, Greece / Second Department of Surgery

SURLIN M. V., Craiova Emergency Clinical Hospital, Romania / First Clinic of Surgery

University of Medicine and Pharmacy of Craiova, Romania

References

1. Yang X, Hua R, He K, Shen Q, Yao Q. Laparoscopic hernioplasty of hiatal hernia. Annals of transla-tional medicine 2016; 4(18): 343 / doi: 10.21037/atm.2016.09.03
2. Kohn GP, Price RR, DeMeester SR, et al. Guidelines for the management of hiatal hernia. Surgical endoscopy 2013; 27(12): 4409-4428.
3. Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new "gold standard"? Archives of surgery 1992; 127(8): 917-921.
4. Wadhwa A, Chowbey PK, Sharma A, Khullar R, Soni V, Baijal M. Combined procedures in laparo-scopic surgery. Surgical laparoscopy, endoscopy & percutaneous techniques 2003; 13(6): 382-386.
5. Sasaki A, Nitta H, Otuska K, Kimura Y, Obuchi T, Wakabayashi G: Concomitant laparoscopic sple-nectomy and cholecystectomy. Surgical laparoscopy, endoscopy & percutaneous techniques 2010; 20(2): 66-68.
6. Savita K, Khedkar I, Bhartia VK. Combined procedures with laparoscopic cholecystectomy. The Indian Journal of Surgery 2010; 72(5): 377-380.
7. Clapp B. Optimal Initial Trocar Placement for Morbidly Obese Patients. Journal of the Society of Laparoendoscopic Surgeons 2018; 22(4): e2017.00101
8. Preda SD, Patrascu S, Ungureanu BS, et al. Primary parahiatal hernias: A case report and review of the literature. World Journal of Clinical Cases 2019; 7(23): 4020-4028.
9. Praveen Raj P, Senthilnathan P, Kumaravel R, Rajpandian S, Rajan PS, Anand Vijay N, Palanivelu C. Concomitant laparoscopic ventral hernia mesh repair and bariatric surgery: a retrospective study from a tertiary care center. Obesity surgery 2012; 22(5): 685-689.
10. Birolini C, Utiyama EM, Rodrigues AJ Jr, Birolini D. Elective colonic operation and prosthetic repair of incisional hernia: does contamination contraindicate abdominal wall prosthesis use? Journal of the American College of Surgeons 2000; 191(4): 366-372.
11. De Biasi A, Lumpkins K, Turner PL. Laparoscopic ventral hernia repair with acute perforated chole-cystitis and no short- or long-term evidence of prosthesis infection. The American Surgeon 2011; 77(4): 510-511.
12. Stringer RA, Salameh JR: Mesh herniorrhaphy during elective colorectal surgery. Hernia: the journal of hernias and abdominal wall surgery 2005; 9(1): 26-28.
13. Simon E, Kelemen O, Knausz J, Bodnar S, Batorfi J. Synchronically performed laparoscopic chole-cystectomy and hernioplasty. Acta chirurgica Hungarica 1999; 38(2): 205-207.
14. Kelly ME, Behrman SW: The safety and efficacy of prosthetic hernia repair in clean-contaminated and contaminated wounds. The American Surgeon 2002; 68(6): 524-528.
15. Albasini JL, Aledo VS, Dexter SP, Marton J, Martin IG, McMahon MJ. Bile leakage following lapa-roscopic cholecystectomy. Surgical endoscopy 1995; 9(12): 1274-1278.
16. Bailey RW, Zucker KA, Flowers JL, Scovill WA, Graham SM, Imbembo AL. Laparoscopic chole-cystectomy. Experience with 375 consecutive patients. Annals of Surgery 1991; 214(4): 531-540.
17. Singal R, Sharma A, Zaman M: The Safety and Efficacy of Clipless versus Conventional Laparoscopic Cholecystectomy - our Experience in an Indian Rural Center. Maedica 2018; 13(1): 34-43.
18. Flum DR, Cheadle A, Prela C, Dellinger EP, Chan L. Bile duct injury during cholecystectomy and survival in medicare beneficiaries. JAMA 2003; 290(16): 2168-2173.
19. Gouma DJ, Go PM: Bile duct injury during laparoscopic and conventional cholecystectomy. Journal of the American College of Surgeons 1994; 178(3): 229-233.
20. Roslyn JJ, Binns GS, Hughes EF, Saunders-Kirkwood K, Zinner MJ, Cates JA: Open cholecystecto-my. A contemporary analysis of 42,474 patients. Annals of Surgery 1993; 218(2): 129-137.
Published
2021-03-30