Our Summary

This research paper investigates the outcomes of hiatal hernia repairs (HHR) performed by general surgeons (GS) and thoracic surgeons (TS). Hiatal hernia is a condition where part of the stomach pushes up into the chest through an opening in the diaphragm. The authors used a database to find patients who had this type of surgery between 2014 and 2018.

They found that general surgeons performed the majority of these operations (72%). Importantly, the study found that there was no significant difference in serious complications or deaths between surgeries performed by GS and TS. However, the surgeries performed by GS had a shorter hospital stay (2.57 days vs 2.72 days) and were cheaper on average ($7139 vs $8032).

In simpler terms, whether a general surgeon or a specialist thoracic surgeon performs the surgery doesn’t significantly change the risk of serious issues or death. But, the general surgeons tend to get patients out of the hospital a bit quicker and at a lower cost.

FAQs

  1. What is a hiatal hernia and how is it repaired?
  2. Was there any significant difference in outcomes between surgeries performed by general surgeons and thoracic surgeons?
  3. Is there any cost and hospital stay difference between hiatal hernia repairs performed by general surgeons and thoracic surgeons?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hiatal hernia repair is that the choice between a general surgeon and a thoracic surgeon for the surgery doesn’t significantly impact the risk of complications or death. However, general surgeons may offer a shorter hospital stay and lower cost for the procedure. It’s important to discuss the options with your doctor and choose the surgeon that you feel most comfortable with.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those who experience symptoms such as heartburn, regurgitation, chest pain, difficulty swallowing, and frequent belching. Additionally, patients with complications such as gastroesophageal reflux disease (GERD), Barrett’s esophagus, esophagitis, strictures, or respiratory issues related to the hernia may also be candidates for surgery. Patients who do not respond to medication or lifestyle changes to manage their symptoms may also be recommended for hiatal hernia repair.

Timeline

Before the hiatal hernia repair, the patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, and regurgitation of food. They may undergo diagnostic tests such as an endoscopy or barium swallow to confirm the diagnosis. The patient may also make lifestyle changes such as avoiding certain foods, losing weight, and elevating the head of their bed to help manage symptoms.

After the hiatal hernia repair, the patient will typically stay in the hospital for a few days for monitoring and recovery. They may experience some discomfort and bloating in the days following the surgery. The patient will be advised to follow a special diet and avoid strenuous activities for a period of time to allow for proper healing. Follow-up appointments with the surgeon will be scheduled to monitor the patient’s progress and address any concerns. Over time, the patient should experience a decrease in symptoms such as heartburn and regurgitation, leading to an improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair include:

  1. What are the potential risks and complications associated with hiatal hernia repair surgery?
  2. What is the success rate of this surgery in terms of resolving symptoms and preventing hernia recurrence?
  3. How experienced are you in performing hiatal hernia repair surgeries?
  4. Are there any alternative treatments or procedures that I should consider before opting for surgery?
  5. What is the expected recovery time and post-operative care plan for this surgery?
  6. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  7. How long will I need to stay in the hospital after the surgery?
  8. What type of anesthesia will be used during the surgery and what are the potential side effects?
  9. Will I need to undergo any pre-operative tests or evaluations before the surgery?
  10. Are there any specific instructions or precautions I should follow leading up to the surgery date?

Reference

Authors: Gambhir S, Daly S, Maithel S, Sheehan BM, Nguyen J, Hinojosa MW, Smith BR, Nguyen NT. Journal: Surg Endosc. 2020 Apr;34(4):1621-1624. doi: 10.1007/s00464-019-06926-4. Epub 2019 Jun 18. PMID: 31214801