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Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair

  • 2019 SAGES Oral
  • Published:
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Abstract

Background

Cameron lesions (CL) are common complications of large hiatal hernia (HH) disease and are known to result in chronic blood loss with resultant microcytic anemia. There is support in the literature that repair of HH may lead to resolution of CL and restore normal hemoglobin levels. This study aimed to determine the impact of elective HH repair on resolution of anemia and the quality of life (QOL) in patients with CL.

Method

A single-institution, retrospective review analyzed all patients with history of CL or anemia (hemoglobin < 12.0 gm/dl in women, < 13.5 gm/dl in men) who underwent HH repair from January 2012 to May 2019. Four validated surveys were used to assess QOL: Reflux Symptom Index (RSI), gastroesophageal reflux disease health-related QOL (GERD-HRQL), laryngopharyngeal reflux health-related QOL (LPR-HRQL), and QOL and swallowing disorders (SWAL) survey. History of iron supplements and perioperative hemoglobin were also noted.

Result

Ninety-six patients were included in this study. The mean age was 67.4 ± 10.8 years and 79% of patients were female. CL were endoscopically identified in 61.5% of patients preoperatively, and the rest of the patients experienced anemia of undiagnosed origin but had a high suspicion for CL. Mean follow-up after HH repair was 17.3 months (range, 1 month–5 years). Mean preoperative hemoglobin was 11.01 ± 2.9 gm/dl and 13.23 ± 1.6 gm/dl postoperatively (p < 0.01). Forty-two (73.7%) patients had resolution of anemia during follow-up and 94.5% stopped supplemental oral iron. Finally, QOL scores significantly improved after surgical intervention: RSI (63%), GERD-HRQL (77%), LPR-HRQOL (72%), and SWAL (13%).

Conclusion

Elective HH repair in patients with chronic anemia secondary to CL may potentially resolve CL and anemia and contribute to significant QOL improvements. Future studies will prospectively assess the resolution of CL with biochemical and endoscopic follow-up to confirm the preliminary findings of our analysis.

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. Department of Surgery, Anne Arundel Medical Center, 2000 Medical Parkway, Belcher Pavilion, Suite 106, Annapolis, MD, 21401, USA

    Alex Addo, Andrew Broda, H. Reza Zahiri, Ian M. Brooks & Adrian Park

  2. Johns Hopkins University School of Medicine, Baltimore, USA

    Adrian Park

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  1. Alex Addo
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  2. Andrew Broda
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  3. H. Reza Zahiri
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  4. Ian M. Brooks
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  5. Adrian Park
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All authors certify that they accept responsibility as an author and have contributed to the concept, data gathering, analysis, manuscript drafting, and give their final approval.

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Correspondence to Adrian Park.

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Dr. Park, Addo, Zahiri, Brooks, and Mr. Broda have no conflict of interest or financial or relevant financial ties to disclose.

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Addo, A., Broda, A., Reza Zahiri, H. et al. Resolution of anemia and improved quality of life following laparoscopic hiatal hernia repair. Surg Endosc 34, 3072–3078 (2020). https://doi.org/10.1007/s00464-019-07054-9

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  • DOI: https://doi.org/10.1007/s00464-019-07054-9

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