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Table 1 Case series

From: Minimally invasive laparoscopic and robot-assisted emergency treatment of strangulated giant hiatal hernias: report of five cases and literature review

N Age (y), sex Symptomsa, examinationb, history Comorbidities BMI kg/m2 CT findings Endoscopic findings Waiting time from admission to surgery (days) Approach of hiatoplasty Fundoplication Mesh Gastropexy/gastrostomy Operative time (min) Complications Hospital stay (days) Follow-up (minimum 6 months)
1 70, M Symptomatic GHH None 25.3 GHH with air-fluid level Gastric obstruction 0 Robotic assisted Nissen No None 190 None 4 Uneventful
2c 47, M Weight loss, asymptomatic GHH Depression, obesity 37.5 GHH with air-fluid level Gastric obstruction. Diffuse ischemia of gastric mucosad 0 Robotic assistede No No Foley 18 in the gastric antrum 230 antrum stenosis 21 Mild reflux, Foley removed on PD 35, endoscopic balloon dilatation
3 86, M Weight loss, GERD, symptomatic GHH Hypertension, dyslipidemia 27.4 Gastric volvulus Gastric obstruction 2f Laparoscopic Toupet No Gastrostomy tube 180 None 9 Gastrostomy tube removed on PD 25
4 88, M Asthenia, GERD, asymptomatic GHH Atrial fibrillation in OAT, hypertension, COPD 24.4 GHH with upside-down stomach Gastric obstruction 3 (stop of OAT) Robotic assisted Toupet BIO-A®g Gastrostomy tube 190 None 7 Gastrostomy tube removed on PD 20
5 59, M Coffee ground vomiting, GERD, symptomatic GHH Obesity 32.6 GHH with air-fluid level and signs of gastric wall vascular insufficiency Not performed 0 3D laparoscopic Nissen BIO-A®g Gastropexy 170 None 5 Uneventful
  1. CT computed tomography, GHH giant hiatal hernia, MOF multi organ failure, ICU intensive care unit, GERD gastroesophageal reflux disease, PD postoperative day, OAT oral anticoagulant therapy, COPD chronic obstructive pulmonary disease, BMI body mass index
  2. aAbdominal and thoracic pain, nausea and vomiting were always present. All patients were stable at admission
  3. bIn all cases, there was no/incomplete nasogastric tube progression
  4. cIn this case, elevated white blood cells count and lactate lead to the need of ruling out ischemic heart disease
  5. d5 postoperative days in ICU
  6. eIntraoperative gastroscopy to check the mucosa of the distal stomach
  7. fAttempt of conservative approach
  8. gGore & Associates Inc, Newark, DE, USA