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Laparoscopic repair of large hiatal hernias: clinical outcomes of 10 years
Author(s) -
Chen Zhen,
Zhao Hongzhi,
Sun Xiangyu,
Wang Zhenyu
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14426
Subject(s) - medicine , hiatal hernia , quality of life (healthcare) , dysphagia , surgery , hernia , chest radiograph , heartburn , prospective cohort study , reflux , radiography , disease , nursing
Background Whilst laparoscopic repair is the most common surgical procedure for the treatment of large hiatal hernias, knowledge of long‐term outcomes (>10 years) is scarce. The aim of this study was to evaluate the long‐term results following this approach, in particular the hernia recurrence rate and the impact of repair on quality of life (QoL). Methods Patients were identified from a prospective database. A standardized questionnaire was used to assess symptoms and a barium swallow radiograph was performed to determine anatomy. A validated QoL measure, Gastrointestinal Quality of Life Index (GIQLI) was also applied to all patients. Results Of the 69 eligible patients, clinical follow‐up was available for 54 patients (78.3%). Follow‐up ranged from 72 to 185 (median: 114) months. Post‐operative heartburn and dysphagia were significantly improved, with 45 patients (83%) reporting a good or excellent result. Contrast radiology in 35 patients (65%) revealed recurrence in 12 patients (34%). Fifty‐four patients answered the GIQLI questionnaire. The mean GIQLI score was 117 (61–136). Patients with objectively documented anatomic recurrence had a QoL index of 92 (61–121) compared to an index of 122 (77–136, P < 0.01) in the non‐recurrent hernia group. Conclusions At mean 114 months follow‐up, laparoscopic repair of large hiatal hernias achieves effective and durable relief of symptoms, and most patients are satisfied with the outcome.