502 Emergency Giant Hiatus Hernia Surgery: Experiences with Post-Operative Complications

Abstract

Abstract Aim Patients with giant hiatus hernias can present acutely with volvulus or strangulation. Early emergency surgical intervention with reduction of the hernia and hiatal repair is shown to reduce the mortality rate. However, surgery is not without risk or complications. This study assessed the rate of complications and length of hospital stay in patients requiring emergency surgery. Method A retrospective study was done looking at all patients who underwent emergency hiatal hernia surgery at a tertiary oesophagogastric centre. Over an eight-year period, 80 patients were identified. Their clinical course was evaluated from medical records, collecting data on their length of stay, complications, and mortality. Results Of the 80 patients, 30 patients (37.5%) had no documented complications from the surgery. 62.5% did have complications, of which respiratory complications were the most frequent (43%). 10% of patients had symptomatic recurrence of the hiatus hernia that required operative correction either during index admission or a subsequent admission. Median length of hospital stay was 8 days (IQR 5–16). There was a positive correlation between number of complications and length of stay. Post-operative mortality was 9%. Conclusions Emergency surgery for hiatus hernias has a high morbidity rate, as expected for an emergency procedure in acutely unwell patients. Despite the high rate of post-operative complications, the length of hospital stay was relatively short with low mortality, showing emergency surgery to be an effective lifesaving treatment.