Can a Hiatal Hernia Come Back After Surgery
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PREDICTORS OF HIATAL HERNIA RECURRENCE AFTER LAPAROSCOPIC ANTI-REFLUX SURGERY WITH HIATAL HERNIA REPAIR: A PROSPECTIVELY Collected DATABASE ANALYSIS
Priscila R. Armijo, Spyridon Pagkratis, Dmitry Oleynikov*
University of Nebraska Medical Center, Omaha, NE
Introduction
The charge per unit of radiographic hiatal hernia (HH) recurrence subsequently anti-reflux surgery has been reported to exist from xv% to 60%. While many recurrences are but radiographic with patients remaining asymptomatic, factors that tin predict recurrence are non well understood. The aim of this study is to place those factors that can predict HH recurrence in patients later on anti-reflux surgery with HH repair.
Methods
A single-establishment, prospectively-collected database was reviewed for patients with diagnosis of GERD who underwent laparoscopic anti-reflux surgery with HH repair between January 2002 and October 2015. Demographics and esophageal symptoms scores were collected. Likewise, mesh usage, HH type (sliding, paraesophageal or type Four) and size (small, moderate and large) were evaluated. Hernia recurrence was assessed post operatively with upper GI contrast study (UGI). Comparison was done for patients who had HH recurrence (HHR) versus those who did non (NHHR). Statistical analysis was performed using IBM SPSS v.23.0.0, with α=0.05.
Results
A total of 691 patients underwent anti-reflux surgery in this period with 304 who had HH repair and returned for UGI. Hateful age was 56 � xiv.3 years, 39% male and 61% female, and mean follow-upwardly of time was xx � 23.9 months. All 304 patients had laparoscopic arroyo, 90.8% had a full fundoplication and 9.2% underwent a partial fundoplication. Overall HH recurrence rate was 24.7%. Patients who had HH recurrence were significantly older and had larger HH compared to the NHHR group (Tabular array 1). Similarly, HHR patients had higher rates of paraesophageal hernias at the time of the anti-reflux surgery than NHHR patients. There was no pregnant difference between the groups for the variables of gender, BMI, race, and mesh usage. Amid all patients with HH recurrence, only 14 patients (18.half dozen%) reported mild to moderate heartburn, regurgitation, solid or liquid dysphagia at follow-up. Reoperation rate was iii% in this patient population.
Conclusion
Hiatal hernia recurrence was correlated with larger hernias at time of surgery and advanced patient age. Use of mesh and patient BMI were not predictive of either recurrence or symptomatic failures. Furthermore, no correlation was identified between hiatal hernia recurrence and presence of gastroesophageal reflux symptoms. Hiatal hernia recurrence after repair is relatively common only appears to exist asymptomatic in the majority of cases. Reoperation is rare every bit near patients practice not develop symptoms. Mesh is not routinely needed and very big paraesophageal hernias in the elderly will commonly develop asymptomatic radiographic recurrences that exercise non require intervention.
Dorsum to 2022 Posters
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Source: http://meetings.ssat.com/abstracts/2017/Su1094.cgi
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