Quality of life after giant hiatus hernia repair

Abstract

Background: Elective surgery is the treatment of choice for symptomatic giant hiatus hernia (GHH), and quality of life (QoL) has become an important outcome measure following surgery. The aim of this study is to review the literature assessing QoL following repair of GHH. Methodology: A systematic literature search was performed by two reviewers independently to identify original studies evaluating QoL outcomes after GHH surgery. MeSH terms such as paraoesophageal; hiatus hernia; giant hiatus hernia and quality of life were used in the initial search. Original studies in English language using validated questionnaires on humans were included. Review articles, conference abstracts and case reports and studies with duplicate data were excluded. Results: Two hundred and eight articles were identified on initial search, of which 38 studies (4404 patients) were included. Studies showed a significant heterogeneity in QoL assessment tools, surgical techniques and follow-up methods. All studies assessing both pre-operative and post-operative QoL ( n = 31) reported improved QoL on follow-up after surgical repair of GHH. Improvement in QoL following GHH repair was not affected by patient age, surgical technique or the use of mesh. Recurrence of GHH after surgery may, however, adversely impact QoL. Conclusion: Surgical repair of GHH improved QoL scores in all the 38 studies. The impact of recurrence on QoL needs further assessment. The authors also recommend uniform reporting of surgical outcomes in future studies.

Could “Low Quality of Life” Rather Than “Significant Symptoms” Be Better Criteria for the Selection of Patients for the Repair of a Giant Hiatus Hernia?

“…Of the 56 patients who underwent operative management, there were no mortalities, and four patients (7.1%) required a re-operation for recurrence demonstrating that GHH repair is a safe operation with low recurrence rates and excellent QoL improvement up to two years postoperation. This finding is consistent with Date et al's systematic review of QoL post-GHH repair [16]. The QOLRAD tool demonstrated significant improvements in all QoL domains.…”

Quality of life following repair of large hiatal hernia is not influenced by the use of mesh—Longer‐term follow‐up from a randomized trial

“…Five out of these six studies reported no statistically significant differences between the two groups. 24 An important finding in our study was that prior to repair patients with large hiatus hernias had significantly worse quality of life outcomes than the general population of that age group (>65 years), and after surgery the physical and mental component scores and subscales scores returned to levels similar to the general population, confirming the significant benefit of laparoscopic repair of large hiatus hernia.…”