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Effects of Spinal Deformities on Hiatal Hernia Occurrence and Recurrence

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Spinal deformities such as kyphosis, lordosis, and scoliosis have demonstrated a possible association between these deformities. Our hypothesis is that the presence of spinal deformities will increase the risk of hiatal hernia recurrence after repair.

Methods

The following data was retrospectively gleaned for patients undergoing hiatal hernia repair (1997–2022): age, sex, date of hiatal hernia repair, presence and type of spinal deformity, Cobb angle, type of hiatal hernia and size, type of hiatal hernia repair, recurrence and size, time to recurrence, reoperation, type of reoperation, and time to reoperation.

Results

Spinal deformities were present in 15.8% of 546 patients undergoing hiatal hernia repair, with a distribution of 21.8% kyphosis, 2.3% lordosis, 58.6% scoliosis, and 17.2% multiple. There was no difference in sex or age between groups. Spinal deformity patients were more likely to have types III and IV hiatal hernias (52.3% vs. 38.9%, p = 0.02) and larger hernias (median 5 [3-8] vs. 4 [2-6], p = 0.01). There was no difference in access, fundoplication use, or mesh use between groups. However, these patients had a higher recurrence rate (47.7% vs 30.0%, p = 0.001) and a shorter time to recurrence (months) (10.3 [5.6-25.1] vs 19.2 [9.8-51.0], p = 0.02). Cobb angle did not affect recurrence.

Conclusions

Spinal deformity patients were more likely to have more complex and larger hiatal hernias. They were at higher risk of hiatal hernia recurrence after repair with shorter times to recurrence. This is a group that requires special attention with additional preoperative counseling and possibly use of surgical adjuncts in repair.

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Data Availability

Data can be made available upon request.

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Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA

    Naveen Perisetla BS, William N. Doyle Jr BS, Lauren Ladehoff BS, Nicole Natarelli BS, Valerie Nemov BS, Karthik Pittala BS, Joseph Sujka MD, Adham R. Saad MD, Chistopher DuCoin MD & Vic Velanovich MD

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  1. Naveen Perisetla BS
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  2. William N. Doyle Jr BS
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  3. Lauren Ladehoff BS
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  4. Nicole Natarelli BS
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  5. Valerie Nemov BS
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  6. Karthik Pittala BS
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  7. Joseph Sujka MD
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  8. Adham R. Saad MD
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  9. Chistopher DuCoin MD
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  10. Vic Velanovich MD
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Correspondence to Vic Velanovich MD.

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Conflict of Interest

Naveen Perisetla, William N. Doyle, Jr, Lauren Ladehoff, Nicole Natarelli, Valerie Nemov, Karthik Pittala, Joseph Sujkve, Adham R. Saad, and Chistopher DuCoin has nothing to disclose. Vic Velanovich is a consultant for Enterra Medical, Inc.

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Perisetla, N., Doyle, W.N., Ladehoff, L. et al. Effects of Spinal Deformities on Hiatal Hernia Occurrence and Recurrence. J Gastrointest Surg 27, 2718–2723 (2023). https://doi.org/10.1007/s11605-023-05877-5

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  • DOI: https://doi.org/10.1007/s11605-023-05877-5

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