Clinical Profile and Laparoscopic Management of Hiatus Hernia: In a Tertiary Care Center

Aim: This study will be useful in evaluating the clinical profile of patients and to assess the outcome of laparoscopic and medical management of gastroesophageal reflux disease (GERD) with hiatus hernia. Materials and methods: We retrospectively analyzed patients who were diagnosed with GERD and hiatus hernia over a period of 4 years and looked for outcomes of laparoscopic fundoplication. Results: A total number of 30 cases between January 2018 and December 2021 were included in this retrospective study with male-to-female ratio of 2:1. Most patients with GERD present with abdominal pain which is localized to the epigastric region. About 72.1% (p-value = < 0.005) of patients had mainly reflux symptoms such as epigastric pain, heartburn, or regurgitation, of which, epigastric pain was the most common (68%). In our study, the most common investigation performed was upper gastrointestinal endoscopy which was able to highlight an underlying pathology in terms of hiatal hernia in 38.5% (p-value = 0.019) patients. Proton pump inhibitors were used more frequently in patients and outcome of medical management varied. Laparoscopic fundoplication is the standard surgical treatment for GERD and has very low complication rates. On routine follow-up of all patients treated surgically for GERD, 67% (p-value = 0.007) had complete symptomatic relief in contrast to medical management, wherein only 22% of patients had long-term symptomatic relief. Conclusion: Laparoscopic total fundoplication is fast being adopted as the surgical gold standard for the treatment of GERD after appropriate trial of medical management among the population presenting in an Indian tertiary care hospital. Clinical significance: The study results would improve treatment outcomes in patients with hiatus hernia.