Chu Yuxiao, Liu Yanyang, Hua Rong, Yao Qiyuan
Center for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China.
Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC Surg. 2025 Jan 11;25(1):18. doi: 10.1186/s12893-025-02760-9.
The management of a recurrent (symptomatic) hiatal hernia remains controversial. This study aimed to review the outcomes of patients who underwent recurrent repair of hiatal hernias.
Thirteen patients who underwent recurrent hiatal hernia repairs at our hospital between 2018 and 2024 were reviewed retrospectively. The postoperative outcomes and complications of these patients were investigated.
Thirteen patients were included in this study. The median time of reoperation from the previous hiatal hernia repair was 3 years (IQR, 2.5-5). Patients with a history of only one repair accounted for 76.9%, whereas those with two repairs accounted for 23.1%. All reoperations were completed laparoscopically. No deaths or readmissions during the 30-day postoperative period were recorded at an average of 30.5 ± 20.9 (6-68) months of follow-up. No other complications or symptoms were recorded, and oral medication was discontinued in eleven (84.6%) patients. The average GERD-Q score was 6.7 ± 1.3 postoperatively, whereas it was 10.4 ± 3.0 preoperatively.
We present several surgical strategies for addressing the recurrence of hiatal hernias. The key is not only to accurately close the hernia ring but also to fix the fundoplication to reduce the impact on the tissue around the hiatus to reduce the incidence of recurrence. Our three-point fixation technique showed promising effects in preventing recurrence but needs further study.
ChiCTR2100049995.
复发性（有症状的）食管裂孔疝的治疗仍存在争议。本研究旨在回顾接受复发性食管裂孔疝修复术患者的治疗结果。
回顾性分析2018年至2024年在我院接受复发性食管裂孔疝修复术的13例患者。调查这些患者的术后结果和并发症。
本研究纳入13例患者。从上一次食管裂孔疝修复术至再次手术的中位时间为3年（四分位间距，2.5 - 5年）。仅接受过一次修复术的患者占76.9%，接受过两次修复术的患者占23.1%。所有再次手术均通过腹腔镜完成。在平均30.5±20.9（6 - 68）个月的随访期内，术后30天内未记录到死亡或再次入院情况。未记录到其他并发症或症状，11例（84.6%）患者停用了口服药物。术后GERD - Q平均评分为6.7±1.3，而术前为10.4±3.0。
我们提出了几种处理食管裂孔疝复发的手术策略。关键不仅在于准确闭合疝环，还在于固定胃底折叠术以减少对裂孔周围组织的影响，从而降低复发率。我们的三点固定技术在预防复发方面显示出有前景的效果，但需要进一步研究。
ChiCTR2100049995。
