Long-term outcomes of surgical treatment in patients of different age groups with hiatal hernia and iron-deficiency anemia

Gastroesophageal reflux disease (GERD) and hiatal hernia are common among older adults and significantly impair quality of life. Although laparoscopic fundoplication is widely used, evidence on the long-term impact of age on surgical outcomes remains limited. Objective. To evaluate long-term outcomes of surgical treatment of hiatal hernia in older patients. Materials and Methods. We analyzed data from 112 patients who underwent surgery between 2018 and 2022; long-term results were available for 84 individuals (follow-up 2.0—6.7 years). All patients underwent laparoscopic fundoplication using the technique developed at the Petrovsky National Research Centre of Surgery. Two groups were defined: ≥60 years (n=44) and <60 years (n=40). Clinical symptoms, endoscopic and CT findings, quality-of-life measures (EuroQol EQ-5D-3L, GERD-HRQL), laboratory parameters, and geriatric status were assessed. Results. Dyspepsia reported by 34 patients, with no significant differences between groups. Hiatal hernia recurrence occurred in 9.1% of older patients and 12.5% of younger patients (p>0.05). Hemoglobin and serum iron normalized in 92.8% of cases, although most patients did not receive targeted iron therapy. Quality-of-life scores were comparable, although mild anxiety was more frequent in patients ≥60 years. No cases of sarcopenia, frailty, or cognitive impairment were identified. Conclusion. Laparoscopic fundoplication performed using the Petrovsky National Research Centre of Surgery technique is highly effective across all age groups, including older adults. Age ≥60 years does not affect recurrence rates, symptom resolution, or quality of life, and should not be considered a contraindication to antireflux surgery. Anatomical recurrences remain a persistent issue requiring further investigation.