Pathogeny analysis and management experience of recurrent hiatal hernia:report of 12 cases

GUAN Lei; ZHAO Min-xian; NIE Yu-sheng; YANG Hui-qi

doi:10.19538/j.cjps.issn1005-2208.2024.04.18

Abstract：Objective To evaluate the pathogeny and management experience of recurrent hiatal hernia.Methods A retrospective study was performed to analyze the clinical data of cases of recurrent hiatal hernia undergoing laparoscopic surgery in Beijing Chao-Yang Hospital of June 2020 to November 2023.The general dates,previous and this operation situation,recurrence type,and postoperative follow-up were analyzed.Results All the cases were diagnosed definitely and completed selective laparoscopic operation including 3 cases with recurrence after thoracotomy repair surgery,and 9 cases with recurrence after laparoscopic surgery.All the cases were placed non-absorbable mesh again and partial fundoplication.Most of the operations were finished successfully under laparoscope with one open conversion case,all the cases with intraoperative mesh placement,8 cases(66.7％)with pre-esophageal recurrence,and 4 cases(33.3％)with retro-esophageal recurrence.Type Ⅲ hernia accounted for the largest proportion(50％).Average operating time 122.5(80-265)min,average blood loss 20.0(5-300)mL,average postoperative hospital stays 5.5(4-8)d.No case was associated with perioperative complications including organ injury or dysfunction,atelectasis,or pneumonia.All the cases were followed up for 2 to 42 months,and no case was reported with severe complications such as mesh infection,long-term chronic pain,intestinal obstruction,and hernia recurrence.Postoperative symptom improvement rate(91.7％),postoperative satisfaction rate(91.7％).Conclusion Anterior recurrence accounted for the largest proportion of hiatal hernia recurrence.Laparoscopic surgery of recurrent hiatal hernia is a safe,feasible,and effective method with satisfactory results.