372 Surgical Management of Hiatus Hernia and Motility Disorders: A Single-Centre Experience with Short-Term Outcomes

Abstract Aim This study aimed to evaluate the clinical presentation, diagnostic workup, surgical approaches, and short-term outcomes of hiatal hernia repair in a series of 27 consecutive patients. Method A retrospective review was conducted on patients who underwent surgical management for hiatus hernia and motility disorders at our institution. Data collected included demographics, presenting symptoms, comorbidities, preoperative investigations, surgical techniques, and 30-day postoperative outcomes. Results The cohort comprised 19 females (70.4%) and 8 males (29.6%) with a median age of 51.6 years (range 32–76). The most common symptoms were reflux (85.2%), dyspepsia (77.8%), nausea (48.1%), and dysphagia (44.4%). Less frequent manifestations included vomiting (33.3%), weight loss (14.8%), iron deficiency anemia (14.8%), gastrointestinal bleeding (11.1%), and respiratory symptoms (18.5%). Preoperative imaging included contrast studies in 70.4% and esophagogastroduodenoscopy (OGD) in all patients, with multiple procedures in some. Endoscopic findings included hiatal hernia (77.8%), esophagitis (37.0%), gastritis/duodenitis (37.0%), Barrett’s oesophagus (18.5%), and suspected achalasia (14.8%). Classification of hernia subtype was inconsistently reported. Laparoscopic repair was performed in 96.3% of cases; one required conversion to open surgery. Fundoplication techniques included Dor (3.7%), Nissen (62.9%), and Toupet (33.3%). Adjunct procedures included hiatus closure (77.8%), gastropexy (40.7%), and cardiomyotomy (14.8%). Intraoperative OGD was used in 11.1%. Postoperative complications occurred in 33.3% of patients, including atelectasis (14.8%), chest infection (11.1%), and one postoperative bleeding (3.7%). Conclusions Laparoscopic hiatal hernia repair is safe and effective with low conversion rates. The frequent coexistence of esophageal pathology highlights the necessity for comprehensive preoperative evaluation. Further studies are warranted to assess long-term outcomes.