PARAESOPHAGEAL HIATAL-HERNIA - A SERIES O F 42 CASES

Between 1979 and May 1994, 42 patients (11 males, 31 females, mean age 72.8 +/- 12.4 years) underwent surgery for paraoesophageal hiatal her nia. In 37 cases, clinical signs had been observed for 64 months on th e average : digestive (32), respiratory (15), cardiac (9). Nine patien ts had iron deficiency anaemia. Eighteen patients had a complication ( acute obstruction : 10, haemorrhage : 6 perforation : 2, lung infectio n : 2). In 5 cases, the complication was the inaugural sign. Surgery w as performed in a emergency situation in 5 cases and deferred emergenc y in 12 and surgery was elective in 25. An antireflux procedure was us ed in 36 cases (Lortat-Jacob (2), Toupet (5), Dor (2), Nissen-Rossetti (27)). Another procedure was also needed in 12 patients. There were n o postoperative deaths and complications occurred in 6 patients (14.9% ). Outcome was known in 40 patients with a mean follow-up of 40.5 mont hs (range 3 to 140 months). Functional results was very good in 35 pat ients (87.5%), good in 3 (7.5%) and poor in 2 (5%). The most satisfact ory immediate results were obtained for patients who had elective surg ery and lit those with a deferred emergency. Use of the Nissen-Rossett i procedure did not have any deleterious effect on these results and n o long-term inconveniences.