%0 Journal Article
%T Cardiovascular Complications of Large Hiatal Hernias: Expanding the Indications for Robotic Surgical Anatomic and Physiologic Repair:  A Review
%A Farid Gharagozloo
%A Mark Meyer
%A Robert Poston
%J World Journal of Cardiovascular Surgery
%P 39-69
%@ 2164-3210
%D 2022
%I Scientific Research Publishing
%R 10.4236/wjcs.2022.123005
%X <strong>Background:</strong> <span style=\"font-family:;\" \"=\"\">Historically, the pathophysiology of Hiatal Hernias (HH) has not been
fully understood. As a result, </span><span style=\"font-family:;\" \"=\"\">the </span><span style=\"font-family:;\" \"=\"\">surgical therapy of HH has focused <span>primarily
on gastrointestinal symptoms and Gastroesophageal Reflux </span>(GERD). This
treatment strategy has been associated with poor relief of symptoms and poor long</span><span style=\"font-family:;\" \"=\"\">-</span><span style=\"font-family:;\" \"=\"\">term outcomes. In fact,
until recently</span><span style=\"font-family:;\" \"=\"\">,</span><span style=\"font-family:;\" \"=\"\"> most
patients with HH have been watched and referred for surgery as a last resort.
Recent experience has shown that a large (giant) Hiatal Hernia (GHH) is a
common problem known <span>to impact adjacent
organs such as the heart</span></span><span style=\"font-family:;\" \"=\"\">s</span><span style=\"font-family:;\" \"=\"\"> and lungs. Those referred for</span><span style=\"font-family:;\" \"=\"\"> sur<span>gical repair often complain of
dyspnea, which is erroneously attributed to </span>pul<span>monary compression or aspiration, but has been shown to be from</span> tamponade caused from compression of the heart by herniated abdominal contents.
This article reviews the present understanding of GHH, the cardiac
complications <span>which result from GHH, and the
most advanced robotic minimally invasive </span>surgical approach to the
anatomic and physiologic repair of GHH. <b>Methods: </b>In a prospective cohort
study, we evaluated patients undergoing RRHH with <span>at least a 2-year follow-up. All patients undergoing elective (RRHH)
were </span>iden<span>tified preoperatively and
enrolled prospectively in this study. Preoperative </span>cha</span><span style=\"font-family:;\" \"=\"\">racteristics, medical
comorbidities, and clinical information were all recorded <span>prospectively and recorded into a secure surgical
outcomes database. All pa</span>tients <span>received
the previously validated Gastroesophageal Reflux Dis</span>ease</span><span style=\"font-family:;\" \"=\"\">-</span><span style=\"font-family:;\" \"=\"\">Health-Re</span><span style=\"font-family:;\" \"=\"\">lated
Quality of Life (GERD-HRQL) questionnaire preoperatively and at </span><span style=\"font-family:;\" \"=\"\">postoperative time points of 1 month,</span><span style=\"font-family:;\" \"=\"\"> </span><span style=\"font-family:;\" \"=\"\">1 year, and 2 years. Patients routinely had a barium
swallow
%K Hiatal Hernia
%K GERD
%K Paraesophageal Hernia
%K Robotic Surgery
%K Laparoscopic Repair
%K Nissen
%K Belsey
%K Gastroesophageal Valvuloplasty
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=115968