Surgery Today

, Volume 36, Issue 2, pp 131–134

Efficacy of a Proton Pump Inhibitor Given in the Early Postoperative Period to Relieve Symptoms of Hiatal Hernia After Open Heart Surgery

Authors

  • Mitsumasa Hata
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Motomi Shiono
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Hisakuni Sekino
    • Sekino Hospital
  • Hidekazu Furukawa
    • Sekino Hospital
  • Akira Sezai
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Mitsuru Iida
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Isamu Yoshitake
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Tsutomu Hattori
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Shinji Wakui
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Makoto Taoka
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Nanao Negishi
    • Department of Cardiovascular SurgeryNihon University School of Medicine
  • Yukiyasu Sezai
    • Department of Cardiovascular SurgeryNihon University School of Medicine
Article

DOI: 10.1007/s00595-005-3108-2

Cite this article as:
Hata, M., Shiono, M., Sekino, H. et al. Surg Today (2006) 36: 131. doi:10.1007/s00595-005-3108-2

Abstract

Purpose

To evaluate the efficacy of a proton pump inhibitor, we retrospectively reviewed patients who underwent gastric fiberscopy (GFS) in the early phase after cardiac surgery.

Methods

The subjects were 103 patients who underwent GFS for poor appetite, gastric pain, heartburn, or hematemesis after cardiac surgery. We divided the patients into two groups: group I consisted of 49 patients who received an H2-receptor antagonist (ranitidine hydrochloride 300 mg/day), and group II consisted of 54 patients who received a proton pump inhibitor (PPI; sodium rabeprazole 10 mg/day) as prophylactic treatment. The incidence of upper gastrointestinal (GI) disease was compared in the two groups.

Results

Gastric fiberscopy confirmed that 82.5% of the patients had type I hiatal hernia. The incidences of gastric pain and heartburn were significantly higher in group I (12.2% and 83.7%) than in group II (0% and 37.0%). Moreover, gastric bleeding occurred in two patients from group II, one of whom died of coagulopathy. The incidences of hemorrhagic gastritis, active ulcer, and reflux esophagitis were significantly higher in group I than in group II, at 22.4%, 22.4%, and 24.5% vs 1.9%, 0%, and 7.4%.

Conclusions

Early postcardiotomy GFS confirmed a high incidence of type I hiatal hernia. However, the proton pump inhibitor given in the early postoperative period proved more effective than the H2-receptor antagonist for relieving GI symptoms and preventing upper GI disorders after cardiac surgery.

Key words

Open heart surgeryProton pump inhibit-orGastrointestinal diseaseHiatal herniaReflux esophagitis

Copyright information

© Springer-Verlag Tokyo 2006