Abstract
Abstract Background & Aims Surgery is required for medically fit symptomatic CIS patients to avoid complications (volvulus, obstruction & strangulation) that have high morbidity & mortality. To assess the long term outcome including QOL (quality of life) for patients who underwent laparoscopic biological hiatal mesh reconstruction for CIS (100%). Methods Retrospective analysis of a prospectively collected of 34 CIS of 154 consecutive GPEH(Giant Para-Esophageal Hernia) patients intervened between March 2008- December 2023 in a large DGH. Data collected included demographics, BMI, ASA, Preoperative investigations (OGD & Computerised Tomography), operative details including complications, & standardised GERD-Health Related Quality of Life Questionnaire(GERD-QOL) scores of 0-5, 6-10, 11-15 & more than 15 as excellent, good, fair & poor respectively (pre-operatively, 6-month post-operative & long-term), postoperative diet, SOB (shortness of breath) & patient satisfaction. Results 34 included M:F 11: 23, age 72*(45-83) years, BMI 29 *(20-43), ASA III *(II-III). 20(59%), 20(59%), 18(53%), 14(41%), 14(41%) & 12(35%) had heartburn, dysphagia, retrosternal discomfort, vomiting, weight loss and SOB respectively. 6 (18%) emergencies, 22 (65%) incomplete OGDs, operative time 210* (150-510) mins, 1(3%) conversion, 3*(9%) surgical mortality & PO stay 3*(2-27) days. Pre and 6-month post surgery GERD-QOL poor (≥15) & excellent (<5) in 21(62%) & 32(94%) respectively with 32(94%) excellent satisfaction. Follow up at 102*(16-190) months had 2 more unrelated deaths, 21(72%) contacted with GERD-QOL excellent (<5) in 14(67%), poor 1(5%), 19(90%) solid diet, 2(10%) SOB with 19(90%) excellent satisfaction. Conclusion Favourable long term outcome achieved here supports complex surgery for this debilitating condition in the medically fit symptomatic elderly patients. * Median
Published Version
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