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Delayed Gastric Emptying Following Laparoscopic Repair of Very Large Hiatus Hernias Impairs Quality of Life

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Abstract

Background

Delayed gastric emptying (DGE) following hiatus hernia surgery may affect a substantial number of patients with adverse clinical consequences. Here, we aim to evaluate the impact of DGE following laparoscopic repair of very large hiatus hernias on patients’ quality of life, gastrointestinal symptomatology, and daily function.

Methods

Analysis of data collected from a multicenter prospective randomised trial of patients who underwent laparoscopic mesh versus sutured repair of very large hiatus hernias (>50% of stomach in chest). DGE was defined as gastric food retention visualised at endoscopy after 6 h of fasting at 6 months post-surgery. Quality of life (QOL), gastrointestinal symptomatology, and daily function were assessed with the SF-36 questionnaire, Visick scoring and structured surveys administered prior to surgery and at 1, 3, 6 and 12 months after surgery.

Results

Nineteen of 102 (18.6%) patients had DGE 6 months after surgery. QOL questionnaires were completed in at least 80% of patients across all time points. Compared with controls, the DGE group demonstrated significantly lower SF-36 physical component scores, delayed improvement in health transition, more adverse gastrointestinal symptoms, higher Visick scores and a slower rate of return to normal daily activities. These differences were still present 12 months after surgery.

Conclusions

DGE following large hiatus hernia repair is associated with a negative impact on quality of life at follow-up to 12 months after surgery.

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Acknowledgements

This research was supported by project grants from the National Health and Medical Research Council (NHMRC) of Australia (375111 and 1022722).

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Authors and Affiliations

  1. Department of Surgery, Austin Hospital, 145 Studley Road, Heidelberg, VIC, 3084, Australia

    David S. Liu, Chek Tog, Hou K. Lim, Peter Stiven & Ahmad Aly

  2. Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia

    David S. Liu

  3. University of Adelaide Discipline of Surgery, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia

    Sarah K. Thompson

  4. Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, SA, 5042, Australia

    David I. Watson

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  1. David S. Liu
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  2. Chek Tog
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  5. Sarah K. Thompson
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  6. David I. Watson
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  7. Ahmad Aly
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Contributions

DSL and CT performed data acquisition and analysis. DSL, CT, PS and HKL were involved in the interpretation of the data. CT, DSL, HKL, SKT, PS, DIW and AA contributed to study design as well as preparing, editing, reviewing and approving the submitted manuscript.

Corresponding author

Correspondence to David S. Liu.

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Conflict of interests

The authors declare that they have no conflict of interests.

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Liu, D.S., Tog, C., Lim, H.K. et al. Delayed Gastric Emptying Following Laparoscopic Repair of Very Large Hiatus Hernias Impairs Quality of Life. World J Surg 42, 1833–1840 (2018). https://doi.org/10.1007/s00268-017-4362-3

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  • DOI: https://doi.org/10.1007/s00268-017-4362-3

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