A03 - BN Long Term Quality of Life Outcomes Following the Surgical Management of Complete Intrathoracic Stomach (CIS)
Year: 2024
Type: conference-abstract
Abstract: Background Surgery is indicated for symptomatic patients with complete intrathoracic stomach (CIS) to avoid complications (volvulus, obstruction and strangulation) associated with high morbidity. There remains limited evidence of the long-term outcomes and improvement in symptoms from this procedure. Previous large studies have been unable to compare pre-operative symptoms with their post-operative data. Although it appears the procedure has favourable outcomes, further data is required to demonstrate a significant improvement in quality of life (QoL). We therefore aim to assess the long-term outcomes, including changes to QoL and satisfaction, for patients who underwent laparoscopic biological hiatal mesh reconstruction for CIS (100%). Method Prospective data was collected from 154 consecutive GPEH (Giant Hiatus Hernia) patients intervened between March 2008- December 2023 in a large DGH. Retrospective analysis of this identified a subgroup of 34 patients with CIS. All patients underwent a laparoscopic repair with biological mesh, apart from one patient who underwent gastropexy. Outcome measures included both pre-operative and post-operative standardised GERD-Health Related Quality of Life Questionnaire (GERD-QOL) scores; complications; and patient satisfaction. Results Thirty-four patients were included (11 male:23 female) with a mean age 72 (45-83) years. All patients were symptomatic pre-operatively with heartburn (59%), dysphagia (59%), retrosternal discomfort (53%), vomiting (41%), weight loss (41%) or shortness of breath (35%). There were 4 (12%) complications and 3 (9%) 30-day mortalities. Follow up GERD-QOL questionnaires displayed 32/34 (94%) excellent scores (defined as total <5) at 6 months and 15/21 (71%) excellent scores after a median follow up of 8.5 years (72% response rate, 2 further mortalities). This demonstrated a significant improvement in scores following the procedure and long term (p<0.001). Nineteen patients (90%) were satisfied with the procedure after long term follow up (median 8.5 years). Conclusion Laparoscopic repair of complete intrathoracic stomach in this large single-centre study has demonstrated a significant improvement in symptoms and satisfaction over a median 8.5 year follow-up.
Source: British journal of surgery
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4404282359