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Comment
. 2024 Oct;28(5):1817-1822.
doi: 10.1007/s10029-024-03088-8. Epub 2024 Jun 19.

Cruroplasty as a standalone treatment for recurrent hiatal hernia repair

Ashley Tran  1 , Luke R Putnam  1 , Lucy Harvey  1 , John C Lipham  2
Affiliations
Comment

Cruroplasty as a standalone treatment for recurrent hiatal hernia repair

Ashley Tran et al. Hernia. 2024 Oct.

Abstract

Purpose: Following laparoscopic anti-reflux surgery (LARS), recurrence of hiatal hernia is common. Patients with symptomatic recurrence typically undergo revision of the fundoplication or conversion to magnetic sphincter augmentation (MSA) in addition to cruroplasty. However, patients with an intact fundoplication or MSA may only require repeat cruroplasty to repair their recurrent hiatal hernia. The purpose of this study is to compare outcomes following cruroplasty alone compared to full revision (i.e. redo fundoplication or MSA with cruroplasty) for the management of recurrent hiatal hernias.

Methods: A retrospective review of patients undergoing surgical revision of a symptomatic recurrent hiatal hernia between February 2009 and October 2022 was performed. Preoperative characteristics, intraoperative details, and postoperative outcomes were compared between patients undergoing cruroplasty alone versus full revision.

Results: A total of 141 patients were included in the analysis. 93 patients underwent full revision, and 48 patients underwent cruroplasty alone. The mean time between initial and revisional surgery was 8 ± 7.7 years. There was no significant difference in operative time or rates of intra-operative or post-operative complication between groups. Patients undergoing cruroplasty alone had a mean Gastroesophageal Reflux Disease Health Related Quality Life (GERD-HRQL) Questionnaire score of 9.6 ± 10.2 compared to a mean score of 8.9 ± 11.2 for full revision patients (p = 0.829). Recurrence rates following revision was 10.4% for cruroplasty alone patients and 11.8% in full revision patients (p > 0.999).

Conclusion: In patients with intact fundoplication or MSA, cruroplasty alone results in similar post-operative outcomes compared to full revision for recurrent hiatal hernia.

Keywords: Antireflux surgery; Cruroplasty; Fundoplication; Hiatal hernia.

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Conflict of interest statement

Dr. Ashley Tran, Dr. Luke R Putnam, Lucy Harvey, and Dr. John C Lipham declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Comparison of median operative time between full revision and cruroplasty alone
Fig. 2
Fig. 2
Comparison of mesh use during full revision or cruroplasty alone
See this image and copyright information in PMC

Comment on

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