Hiatal hernia after robotic-assisted coronary artery bypass graft surgery.

Autor: Abazid RM; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Khatami A; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Romsa JG; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Warrington JC; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Akincioglu C; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Stodilka RZ; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada., Fox S; Division of Cardiac Surgery, London Health Sciences Centre, London, Canada., Kiaii B; Division of Cardiac Surgery, London Health Sciences Centre, London, Canada.; Division of Cardiac Surgery, University of California, Davis Medical Center, Sacramento, CA, USA., Vezina WC; Division of Nuclear Medicine, London Health Sciences Centre, Victoria Hospital, London, Canada.
Jazyk: angličtina
Zdroj: Journal of thoracic disease [J Thorac Dis] 2021 Feb; Vol. 13 (2), pp. 575-581.
DOI: 10.21037/jtd-20-2557
Abstrakt: Background: The aim of the present study is to determine the incidence/progression of hiatal hernia (HH) after robotic-assisted coronary artery bypass grafting (RA-CABG) surgery.
Methods: We reviewed the pre- and post-operative computed tomography (CT) of 491 patients who underwent RA-CABG between 2000 and 2017. Post-operative CT was acquired prospectively in a research protocol. CT was reviewed to assess the presence and the size of HH.
Results: We found 444/491 (90.4%) had pre-operative CT, while 201/491 (40.9%) had post-operative CT. In total, 155/491 (31.6%) had both pre- and long-term post-operative CT with a mean follow-up of 6.2 (±3.5) years. HH was more prevalent on post-operative CT, 64/155 (41.3%) compared to pre-operative CT, 44/155 (28.4%), P<0.0001. The diameter of pre-existing HH 2.8 (±1.8) cm was significantly greater after surgery 3.9 (±2.5) cm, P<0.0001. As well the volume of the pre-existing HH 5.8 (4.4-9.2) mL (quartile) was significantly greater after surgery 14.1 (7.2-64.9) mL, P<0.0001. 20/155 (12.9%) had a newly developed HH after RA-CABG. A binary multivariate regression including HH risk factors showed that male gender is a predictor of developing a HH after RA-CABG with Hazard Ratio of 3.038, confidence interval (1.10-8.43), P=0.033.
Conclusions: RA-CABG is associated with an increased risk of developing HH and increases the size of pre-existing HH.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-2557). RMA, JGR, BK and WCV report other from Lawson Research Institute, London, Ontario, Canada, during the conduct of the study. The other authors have no conflicts of interest to declare.
(2021 Journal of Thoracic Disease. All rights reserved.)
Databáze: MEDLINE