IMPACT OF HIATAL HERNIA RECURRENCE ON QUALITY OF LIFE: A COMPARATIVE ANALYSIS AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION sbertona@hospitalaleman.com

PE014

IMPACT OF HIATAL HERNIA RECURRENCE ON QUALITY OF LIFE: A COMPARATIVE ANALYSIS AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION

5

Argentina

Oral only

Hiatal hernia (HH) is a common cause of gastroesophageal reflux. In symptomatic patients with poor response to proton pump inhibitors (PPIs) or large hernias, laparoscopic hernia repair and fundoplication is the standard treatment. However, long-term recurrence is common. This study aimed to compare quality-of-life in patients with and without HH recurrence after laparoscopic Nissen fundoplication (LNF).

We performed a retrospective analysis of a consecutive series of patients undergoing LNF for HH between 2015-2024 and divided into recurrence (RR) and non-recurrence (NR) groups, confirmed by endoscopy and/or imaging. A questionnaire evaluated symptoms, PPIs use, and surgical satisfaction. Symptoms were assessed with a Likert scale from 0 to 5.

63 patients were included; 21 (33.3%) RR and 42 (66.6%) NR. Mean HH size was similar between groups. Mesh placement did not differ significantly. Mean follow-up was 38.3 months. 49 patients completed the survey: 14 (28.6%) RR and 35 (71.4%) NR. In the NR group, significant postoperative improvement was observed in symptoms, including heartburn when lying down, after meals, and at rest (all p< 0.00001). RR group showed less and non-significant improvement, with persistent abdominal bloating, dysphagia, and retrosternal pain. Satisfaction was lower among RR patients (5.6 vs 8.3; p=0.003) and a lower proportion would recommend surgery. PPI use was high in both groups, but NR group more frequently reduced their dose (46.1% vs 8.3%; p=0.02).

LNF improves reflux symptoms; however, HH recurrence negatively impacts postoperative outcomes and quality of life, underlining the importance of patient selection and surgical refinements to reduce recurrence.