Poor Metabolic Profile Is an Independent Risk Factor for Recurrence After Hiatal Hernia Repair When Using Tension-Free Mesh.

The effect of metabolic risk factors on the recurrence rate of hiatal hernia (HH) after the initial repair is still controversial. In this study, we evaluated whether a poor preoperative metabolic profile is a risk factor for the recurrence of a HH after surgery. Perioperative patient data were obtained from hospital records. A poor metabolic profile was defined as having two or more metabolic conditions such as diabetes, hypertension, hyperlipidemia, or being overweight. The recurrence rates of HH were measured at 6 months, and again at 12 months after surgery. Data were collected from a total of 221 patients. While 87 (39.4%) patients underwent tension-free mesh (TFM) repair, 137 (60.6%) were treated with suture repair. The poor metabolic profile has no effect on the recurrence rates in the suture-repair group. However, patients who underwent TFM repair displayed a significantly higher recurrence rate at the 12-month time point if they had poor metabolic profile, compared to the healthy group (respectively, 20.7% and 3.4%,  < .01). The logistic regression analysis showed that having a poor metabolic profile was an independent risk factor for recurrence after 12 months in the same group (odds ratio: 8.04 confidence interval [CI: 1.2-53.5]  = .03). The poor metabolic profile was found to be responsible for high recurrence rates only in patients who underwent TFM HH repair.