Subjective outcome after laparoscopic hiatal hernia repair for intrathoracic stomach.
OBJECTIVE
For decades, an intrathoracic stomach (ITS) has been a definite indication for surgery due to the perceived risk of an acute volvulus with perforation, gangrene, or hemorrhage. At the present time, elective laparoscopic repair is the first choice for treatment of ITS. There is a lack of evidence in the long-term quality of life after a hiatal hernia repair for an intrathoracic stomach.


METHODS
A retrospective analysis was performed on all patients undergoing a hiatal hernia repair for an intrathoracic stomach between January 2004 and January 2015. Additionally, to a hiatal closure, the patients received an antireflux procedure. Outcome measures included patient characteristics, operative details, complications, and postoperative morbidity and mortality. All patients were sent a quality of life questionnaire to assess long-term quality of life and patient satisfaction. A higher quality of life score represents a better quality of life.


RESULTS
Eighty-six patients underwent laparoscopic repair for ITS, from which, one patient died during surgery. Eighty-five patients were contacted and 81 completed the questionnaire, resulting in a response rate of 95.3 %. At a median follow-up of 2.7 years (range 0.1-9.6), the mean quality of life score was 13.5 (standard deviation 2.8). The mean overall satisfaction was 8.4. There were four recurrences: three in the first 12 days after surgery and one in 2.4 years.


CONCLUSIONS
Very good results in patient satisfaction and symptom reduction were achieved after a median follow-up of 2.7 years in this laparoscopic repair of the intrathoracic stomach single center experience study. The symptomatic recurrence rate was very low.
Departement of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
P S S
PSS
Castelijns
Departement of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
J E H
JEH
Ponten
Departement of Surgery, MUMC+, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. mcg.vandepoll@maastrichtuniversity.nl.|Department of Intensive Care Medicine, MUMC+, P. Debeyelaan 25, 6229 HX, Maastricht, The Netherlands. mcg.vandepoll@maastrichtuniversity.nl.|School of Nutrition and Translational Research in Medicine, Maastricht University, Maastricht, The Netherlands. mcg.vandepoll@maastrichtuniversity.nl.
M C G
MCG
Van de Poll
Departement of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
S W
SW
Nienhuijs
Departement of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
J F
JF
Smulders
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome
Fundoplication; Hiatal hernia; Intrathoracic stomach; Long-term follow-up; Nissen; Quality of life