Changes in Respiratory Function Following Transthoracic-Transdiaphragmatic or Abdominal Hiatus Hernia Repair

Abstract

Lung function studies were performed pre- and postoperatively in 43 subjects. Thirty-one subjects with hiatus hernia were operated upon either by the transthoracic-trans-diaphragmatic approach (17) or by an abdominal route (14). Twelve subjects without hiatus hernia, who were thorac-otomized for diseases affecting neither heart nor lungs, were included in order to study the effect of left-sided thoracotomy per se on lung function. Subjects operated upon for hiatus hernia transthoracically, including incision in the diaphragm, showed significant decreases in VC, TLC, FRC, and FEV₁A significant decrease in FRC_r localized to the left base was also recorded. Apart from an increase in WOV, the abdominally operated subjects showed no significant changes. No significant changes were registered in subjects after the left-sided thoracotomy. Incision in the diaphragm, scar formation or nerve injury with secondary impairment in the diaphragmatic function seem to be responsible for the reduction in respiratory function after the transthoracic-trans-diaphragmatic approach.