Quality of life after giant hiatus hernia repair: A systematic review
Akshay R Date1, Yan Mei Goh2, Yan Li Goh3, Ilayaraja Rajendran4, Ravindra S Date5
1 Department of Orthopaedic Surgery, Basildon and Thurrock University Hospital, Basildon, Essex, UK
2 Department of Surgery, Imperial College London, St Mary's Hospital, London, UK
3 National Bowel Research Centre (NBRC), Blizzard Institute, Queen Mary University of London, London, UK
4 Department of Upper GI Surgery, Lancashire Teaching Hospital NHS Foundation Trust, Chorley, UK
5 Department of Upper GI Surgery, The University of Manchester, Manchester Academic Health Science Centre, Lancashire Teaching Hospital NHS Foundation Trust, Chorley, UK
Akshay R Date,
Basildon and Thurrock University Hospital, Nethermayne, Basildon, Essex SS16 5NL
Source of Support: None, Conflict of Interest: None
Background: Elective surgery is the treatment of choice for symptomatic giant hiatus hernia (GHH), and quality of life (QoL) has become an important outcome measure following surgery. The aim of this study is to review the literature assessing QoL following repair of GHH.
Methodology: A systematic literature search was performed by two reviewers independently to identify original studies evaluating QoL outcomes after GHH surgery. MeSH terms such as paraoesophageal; hiatus hernia; giant hiatus hernia and quality of life were used in the initial search. Original studies in English language using validated questionnaires on humans were included. Review articles, conference abstracts and case reports and studies with duplicate data were excluded.
Results: Two hundred and eight articles were identified on initial search, of which 38 studies (4404 patients) were included. Studies showed a significant heterogeneity in QoL assessment tools, surgical techniques and follow-up methods. All studies assessing both pre-operative and post-operative QoL (n = 31) reported improved QoL on follow-up after surgical repair of GHH. Improvement in QoL following GHH repair was not affected by patient age, surgical technique or the use of mesh. Recurrence of GHH after surgery may, however, adversely impact QoL.
Conclusion: Surgical repair of GHH improved QoL scores in all the 38 studies. The impact of recurrence on QoL needs further assessment. The authors also recommend uniform reporting of surgical outcomes in future studies.