5-year collis-nissen gastroplasty outcomes for type III-IV hiatal hernia with short esophagus: a prospective observational study

Montcusí Ventura, Blanca; Jaume Böttcher, Sofia Maria; Álvarez, Idoia; Ramón Moros, José Manuel; Sánchez-Parrilla, Juan; Grande Posa, Luís; Pera Román, Manuel

doi:http://dx.doi.org/10.1097/XCS.0000000000000785

5-year collis-nissen gastroplasty outcomes for type III-IV hiatal hernia with short esophagus: a prospective observational study

Citation

Montcusí B, Jaume-Bottcher S, Álvarez I, Ramón JM, Sánchez-Parrilla J, Grande L, et al. 5-year collis-nissen gastroplasty outcomes for type III-IV hiatal hernia with short esophagus: a prospective observational study. J Am Coll Surg. 2023 Oct 1;237(4):596-604. DOI: 10.1097/XCS.0000000000000785

Abstract

Background: To assess the 5-year outcomes of patients undergoing Collis-Nissen gastroplasty for type III-IV hiatal hernia with short esophagus. Study design: From a prospective observational cohort of patients who underwent antireflux surgery for type III-IV hiatal hernia between 2009 and 2020, those with short esophagus (abdominal length <2.5 cm) in whom a Collis-Nissen procedure was performed and reached at least 5 years of follow-up were identified. Hernia recurrence, patients' symptoms, and quality of life were assessed annually by barium meal x-ray, upper endoscopy, and validated symptoms and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaires. Results: Of the 114 patients with Collis-Nissen gastroplasty, 80 patients who completed a 5-year follow-up were included (mean age 71 years). There were no postoperative leaks or deaths. Recurrent hiatal hernia (any size) was identified in 7 patients (8.8%). Heartburn, regurgitation, chest pain, and cough were significantly improved at each follow-up interval (p < 0.05). Preoperative dysphagia disappeared or improved in 26 of 30 patients, while new-onset dysphagia occurred in 6. Mean postoperative QOLRAD scores significantly improved at all dimensions (p < 0.05). Conclusions: Collis gastroplasty combined with Nissen fundoplication provides low hernia recurrence, good control of symptoms, and improved quality of life in patients with large hiatal hernia and short esophagus.