Clinical and Quality of Life Assessment of Patients Undergoing Laparoscopic Hiatal Hernia Repair

Am Surg. 2019 Nov 1;85(11):1269-1275.

Abstract

Hiatal hernia repair (HHR) and fundoplication are similarly performed among all hiatal hernia types with similar techniques. This study evaluates the effect of HHR using a standardized technique for cruroplasty with a reinforcing polyglycolic acid and trimethylene carbonate mesh (PGA/TMC) on patient symptoms and outcomes. A retrospective review of patient perioperative characteristics and postoperative outcomes was conducted for cases of laparoscopic hiatal hernia repair (LHHR) using a PGA/TMC mesh performed over 21 months. Gastroesophageal reflux disease symptom questionnaire responses were compared between preoperative and three postoperative time points. Ninety-six patients underwent LHHR with a PGA/TMC mesh. Postoperatively, the number of overall symptoms reported by patients decreased across all postoperative periods (P < 0.001). Patients reported a significant reduction in antacid use long term (P < 0.001). Laryngeal and regurgitation symptoms decreased at all time points (P < 0.05). There was no difference in dysphagia preoperatively and postoperatively at any time point. Individuals undergoing HHR with PGA/TMC mesh experienced improved regurgitation and laryngeal symptoms, and decreased use of antacid medication.

MeSH terms

  • Absorbable Implants
  • Antacids / therapeutic use
  • Anti-Ulcer Agents / therapeutic use
  • Dioxanes
  • Female
  • Fundoplication / methods*
  • Gastroesophageal Reflux / surgery
  • Hernia, Hiatal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Polyglycolic Acid
  • Quality of Life*
  • Retrospective Studies
  • Surgical Mesh*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antacids
  • Anti-Ulcer Agents
  • Dioxanes
  • Polyglycolic Acid
  • trimethylene carbonate