Our Summary

This study involves a type of stomach condition known as a hiatal hernia (HH), where part of the stomach pushes up into the chest through an opening in the diaphragm. The study looked at 537 patients who underwent a specific type of surgery (laparoscopic fundoplication) to treat HH between 1995 and 2019. The patients were divided into three groups based on the size of their HH.

The researchers found that older patients and women were more likely to have larger HHs. The severity of a related condition, reflux esophagitis (a type of heartburn), was more serious in patients with larger HHs, and the time taken for the surgery was longer for larger HHs.

The study also found that the rate of HH coming back after surgery was higher for larger HHs. However, when the surgeons used a mesh to strengthen the area of the surgery and attached the stomach to the abdominal wall (gastropexy), the recurrence rates went down.

So, the researchers concluded that using a mesh and performing gastropexy can help reduce the chance of HH returning in patients with larger HHs.

FAQs

  1. What is a hiatal hernia and how is it treated through surgery?
  2. Who is more likely to have larger hiatal hernias according to the study?
  3. What techniques were found to reduce the recurrence of hiatal hernia after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to discuss with your surgeon the possibility of using a mesh during the surgery and performing gastropexy to help reduce the risk of the hernia coming back. It’s also important to follow post-operative instructions carefully to ensure a successful recovery.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those with larger HHs, older patients, and women. Additionally, patients with severe reflux esophagitis may also benefit from surgery. Using a mesh and performing gastropexy during surgery can help reduce the chance of HH recurrence in these patients.

Timeline

Before hiatal hernia repair:

  • Patient may experience symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and belching
  • Patient may undergo diagnostic tests such as endoscopy, barium swallow, and pH monitoring to confirm the presence of a hiatal hernia
  • Patient may be advised to make lifestyle changes such as avoiding trigger foods, losing weight, and elevating the head of the bed to alleviate symptoms
  • Patient may be prescribed medications such as proton pump inhibitors to reduce stomach acid production and alleviate symptoms

After hiatal hernia repair:

  • Patient undergoes laparoscopic fundoplication surgery to repair the hiatal hernia
  • Recovery time varies but typically involves a hospital stay of 1-2 days
  • Patient may experience some discomfort, bloating, and difficulty swallowing in the immediate post-operative period
  • Patient is advised to follow a liquid or soft diet for a period of time before gradually transitioning back to solid foods
  • Patient is instructed to avoid heavy lifting and strenuous activities for a period of time to allow for proper healing
  • Patient may be prescribed pain medication and acid-reducing medications to manage symptoms during the recovery period
  • Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns or complications
  • Patient is advised to make lifestyle changes such as maintaining a healthy weight, eating smaller meals, and avoiding trigger foods to prevent recurrence of the hiatal hernia

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. How long is the recovery process after hiatal hernia repair surgery?
  3. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  4. How often do hiatal hernias come back after surgery, and what factors can affect the recurrence rate?
  5. What type of surgical technique will be used to repair my hiatal hernia, and why is it recommended for me?
  6. How experienced is the surgical team in performing hiatal hernia repair surgeries?
  7. Are there any alternative treatment options available for my hiatal hernia?
  8. How will my hiatal hernia repair surgery be personalized to my specific condition and needs?
  9. What are the long-term outcomes and success rates for patients who undergo hiatal hernia repair surgery?
  10. How can I best prepare for the surgery and what steps should I take to ensure a successful recovery process?

Reference

Authors: Yano F, Tsuboi K, Omura N, Hoshino M, Yamamoto SR, Akimoto S, Masuda T, Mitsumori N, Ikegami T. Journal: Asian J Endosc Surg. 2021 Oct;14(4):684-691. doi: 10.1111/ases.12918. Epub 2021 Jan 20. PMID: 33472278