Matsue Seikyo General Hospital, 8-8-8 Nishituda, Matsue 690-8522, Shimane, Japan.
Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Shimane, Japan.
Medicina (Kaunas). 2022 Feb 13;58(2):279. doi: 10.3390/medicina58020279.
: Given Japan's superaging population, an increasing number of older adults in the country need surgical treatment for esophageal hiatal hernias. Accordingly, this systematic review examines surgical interventions for symptomatic esophageal hiatal hernias in older Japanese patients and explores treatment outcomes. : Articles on single operations for hiatal hernias published after 1991 were found on Google Scholar and Ichushi using specific keywords. Subsequently, articles fulfilling the predetermined inclusion criteria were considered in the study. : The mean patient age was 81.4 years, and the male-to-female ratio was 1:11.5. The main reasons for surgery were vomiting, dyspnea, and chest tightness. In terms of hernia classification, type IV was the most common (48%). Surgical modalities were laparoscopy in 15 cases, and laparotomy in 10 cases. Mean postoperative course was 26.47 days until hospital discharge, and there were no cases of perioperative death. : Findings showed that multiple factors were involved in older adults' prognoses, and age was not the only biological factor. Therefore, aggressive surgical intervention should be considered for symptomatic older patients, even in the absence of surgery indicators.
鉴于日本人口的严重老龄化，越来越多的日本老年人需要接受食管裂孔疝的手术治疗。因此，本系统评价考察了日本老年患者有症状的食管裂孔疝的手术干预，并探讨了治疗结果。在 Google Scholar 和 Ichushi 上使用特定的关键词搜索了 1991 年后发表的关于单一疝修补术的文章，然后根据预先确定的纳入标准对文章进行了研究。患者的平均年龄为 81.4 岁，男女比例为 1:11.5。手术的主要原因是呕吐、呼吸困难和胸闷。在疝分类方面，IV 型最常见（48%）。手术方式为腹腔镜 15 例，剖腹 10 例。平均术后住院时间为 26.47 天，无围手术期死亡病例。研究结果表明，老年人的预后涉及多种因素，年龄不是唯一的生物学因素。因此，对于有症状的老年患者，即使没有手术指征，也应考虑积极的手术干预。
