Introduction:

Laparoscopic repair is the standard treatment for giant hiatal hernia. However, despite its low morbidity, recurrence rate remains high. Our goal was to describe the results of laparoscopic repair of giant hiatal hernia, regardless of the technique used for cruroplasty.

Methods:

A retrospective study of patients undergoing laparoscopic repair of giant hiatal hernia was carried out from 2009 to 2017. Demographic data, surgical technique, complications, and hospital stay were analyzed. The results of endoscopy, radiography of upper digestive tract, and GERD-HRQOL symptoms scale, obtained after one year of surgery, were reviewed.

Results:

Forty-four patients with an average hernia size of 7 cm were included. Simple suture cruroplasty was performed in 36.4%, suture plus reinforcement with polytetrafluoroethylene (PTFE) or Dacron in 59.1%, and mesh repair in 4.5%. There were 12 complications, the average hospital stay was 3.5 days, and there was no mortality. Endoscopic or radiological recurrence was found in 6/20 patients, all small and asymptomatic. In 23 patients, the GERD-HRQOL scale reported an average value of 7.7 and 78% patient satisfaction. Only one patient required revision surgery.

Conclusion:

The preferred method of laparoscopic repair of giant hiatal hernia is meshless cruroplasty, a technique associated with low morbidity and adequate symptom control. The recurrence rate is similar to that reported in the literature. Prospective studies with long-term follow-up are required to validate these results.

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