title: Hiatus Hernia Repair with Bilateral Oesophageal Fixation.
abstract: Background. Despite advances in surgical repair of hiatus hernias, there remains a high radiological recurrence rate. We performed a novel technique incorporating bilateral oesophageal fixation and evaluated outcomes, principally symptom improvement and hernia recurrence. Methods. A retrospective study was performed on a prospective database of patients undergoing hiatus hernia repair with bilateral oesophageal fixation. Retrospective and prospective quality of life (QOL), PPI usage, and patient satisfaction data were obtained. Hernia recurrence was assessed by either barium swallow or gastroscopy. Results. 87 patients were identified in the database with a minimum of 3 months followup. There were significant improvements in QOL scores including GERD HRQL (29.13 to 4.38, P < 0.01), Visick (3 to 1), and RSI (17.45 to 5, P < 0.01). PPI usage decreased from a median of daily to none, and there was high patient satisfaction (94%). 57 patients were assessed for recurrence with either gastroscopy or barium swallow, and one patient had evidence of recurrence on barium swallow at 45 months postoperatively. There was an 8% complication rate and no mortality or oesophageal perforation. Conclusions. This study demonstrates that our technique is both safe and effective in symptom control, and our recurrence investigations demonstrate at least short term durability.
authors.affiliation: Westmead Hospital, Sydney, NSW 2145, Australia.
authors.forename: Rajith
authors.identifier: 0000-0001-8446-3288
authors.initials: R
authors.lastname: Mendis
authors.affiliation: University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Caran
authors.identifier: 0000-0001-5963-4751
authors.initials: C
authors.lastname: Cheung
authors.affiliation: Department of Upper GI Surgery, Concord Hospital, Sydney, NSW 2139, Australia ; Department of Upper GI Surgery, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia ; Department of Upper GI Surgery, Strathfield Private Hospital, Sydney, NSW 2135, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Martin