Our Summary

This research paper looked at whether certain metabolic risk factors might influence the rate of recurrence of a type of hernia called a hiatal hernia, after surgery. Metabolic risk factors include things like diabetes, high blood pressure, high cholesterol levels, or being overweight. The study collected data from 221 patients who had undergone surgery to repair a hiatal hernia. They found that having a poor metabolic profile didn’t affect the recurrence rates for those who had one type of surgery (suture repair) but it did significantly increase the recurrence rates for those who had a different type of surgery (tension-free mesh repair). In other words, patients with poor metabolic profiles who underwent tension-free mesh repair were more likely to have their hernia come back than those who were in better health.

FAQs

  1. What are some metabolic risk factors that might influence the recurrence of a hiatal hernia after surgery?
  2. Does having a poor metabolic profile affect the recurrence rates of hiatal hernia for all types of surgeries?
  3. What type of surgery is more likely to have a recurrent hiatal hernia in patients with poor metabolic profiles?

Doctor’s Tip

Therefore, a helpful tip that a doctor might tell a patient about hiatal hernia repair is to focus on improving their metabolic health before undergoing surgery, especially if they are considering tension-free mesh repair. This could involve managing conditions like diabetes, high blood pressure, high cholesterol, and working on weight loss through diet and exercise. By addressing these factors before surgery, patients may have a lower risk of hernia recurrence and better overall outcomes.

Suitable For

Patients who are typically recommended for hiatal hernia repair include those who have severe symptoms such as chronic heartburn, acid reflux, difficulty swallowing, chest pain, or regurgitation of food. Other factors that may indicate the need for surgery include complications such as bleeding, ulcers, or strictures in the esophagus, as well as the presence of a large hiatal hernia that is causing significant discomfort or complications.

Additionally, patients who have not responded well to conservative treatments such as medication, lifestyle changes, or dietary modifications may also be recommended for surgical repair of a hiatal hernia. It is important for patients to discuss their symptoms and medical history with a healthcare provider to determine if surgery is the best course of action for their specific situation.

Timeline

Before hiatal hernia repair:

  • Patient experiences symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation of food or liquid, and stomach acid reflux.
  • Patient may undergo diagnostic tests such as upper endoscopy, barium swallow, and esophageal manometry to confirm the presence of a hiatal hernia.
  • Patient may be prescribed medications such as proton pump inhibitors or H2 blockers to manage symptoms.

After hiatal hernia repair:

  • Surgery is performed to repair the hiatal hernia, typically through either laparoscopic or open surgery.
  • Patient may experience post-operative pain, discomfort, and bloating.
  • Patient is advised to follow a specific diet and lifestyle modifications to prevent recurrence of the hernia.
  • Follow-up appointments with the surgeon are scheduled to monitor recovery and assess any complications.
  • Patient gradually resumes normal activities and should see an improvement in symptoms such as heartburn and acid reflux.

What to Ask Your Doctor

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

  1. What type of surgery is recommended for my hiatal hernia repair?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period after surgery?
  4. Will I need to make any lifestyle changes or follow a specific diet after surgery?
  5. What is the success rate of the surgery in terms of preventing hernia recurrence?
  6. How often will I need follow-up appointments after surgery?
  7. Are there any specific factors, such as metabolic risk factors, that could affect the success of the surgery in my case?
  8. What are the alternatives to surgery for treating a hiatal hernia?
  9. How experienced are you in performing hiatal hernia repair surgeries?
  10. Can you provide me with any patient resources or information to help me prepare for the surgery and recovery process?

Reference

Authors: Eroglu E, Altinli E. Journal: J Laparoendosc Adv Surg Tech A. 2023 Jan;33(1):32-37. doi: 10.1089/lap.2022.0154. Epub 2022 Jun 7. PMID: 35671514