• Blanca Montcusí, Sofia Jaume-Bottcher, Idoia Álvarez, José M Ramón, Juan Sánchez-Parrilla, Luis Grande, and Manuel Pera.
• From the Section of Upper Gastrointestinal Surgery, Department of Surgery, Hospital del Mar Medical Research Institute Universitat Autònoma de Barcelona (Montcusí, Jaume-Bottcher, Álvarez, Ramón, Grande, Pera), Barcelona, Spain.
• J. Am. Coll. Surg. 2023 Oct 1; 237 (4): 596604596-604.

BackgroundTo assess the 5-year outcomes of patients undergoing Collis-Nissen gastroplasty for type III-IV hiatal hernia with short esophagus.Study DesignFrom a prospective observational cohort of patients who underwent antireflux surgery for type III-IV hiatal hernia between 2009 and 2020, those with short esophagus (abdominal length <2.5 cm) in whom a Collis-Nissen procedure was performed and reached at least 5 years of follow-up were identified. Hernia recurrence, patients' symptoms, and quality of life were assessed annually by barium meal x-ray, upper endoscopy, and validated symptoms and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaires.ResultsOf the 114 patients with Collis-Nissen gastroplasty, 80 patients who completed a 5-year follow-up were included (mean age 71 years). There were no postoperative leaks or deaths. Recurrent hiatal hernia (any size) was identified in 7 patients (8.8%). Heartburn, regurgitation, chest pain, and cough were significantly improved at each follow-up interval (p < 0.05). Preoperative dysphagia disappeared or improved in 26 of 30 patients, while new-onset dysphagia occurred in 6. Mean postoperative QOLRAD scores significantly improved at all dimensions (p < 0.05).ConclusionsCollis gastroplasty combined with Nissen fundoplication provides low hernia recurrence, good control of symptoms, and improved quality of life in patients with large hiatal hernia and short esophagus.Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

25 keywords...

hide…