Hiatal Hernias and Respiratory Involvement - Assessment of respiratory symptoms with the surgical correction

Abstract

Introduction: Hiatal hernias are prevalent. Although gastroesophageal reflux related symptoms are more common, hiatal hernias can lead to respiratory symptoms and development or worsening of pulmonary pathologies. Surgical correction of hiatal hernias may be associated with improvement of respiratory symptoms. Objectives: Evaluate the prevalence of respiratory symptoms in patients with indication for surgical correction, evaluate the respiratory symptoms more likely associated with hiatal hernia and evaluate the impact of the surgical intervention on the respiratory symptoms. Methods: Retrospective study of patients submitted surgical hiatal hernia correction in Centro Hospitalar Universitário São João between October 2014 to January 2017. Demographic and clinical data were collected through the Health Electronic Record. Results: Fifty-three patients were included, mean age of 67,2 ± 14,1 years, 37 (69,8%) were females with a preoperative BMI of 28,51 ± 4,5 kg/m2. Most of the patients (86,8%) had, at least, one comorbidity and 11 had a respiratory pathology. Respiratory symptoms were present in 21 (39,8%) preoperative patients, being cough (n=17, 32,7%), dyspnea (n=8 ,15,1%) and wheezing (n=6, 11,3%) the most prevalent. Regarding postoperative respiratory symptoms, there was a reduction of 29,5%, remaining 15 (28,3%) patients with, at least, one respiratory symptom. Cough was present in 11 (20,8%), presenting a reduction of 35,3% and dyspnea in 5 (9,4%) patients with a reduction of 37,5%. Discussion: Surgical correction can reduce these respiratory symptoms and therefore they must be considered when deciding on surgical treatment. We need to consider hiatal hernia as a differential diagnosis in patients with respiratory symptoms.