Related Experiment Video
Updated: Jun 20, 2025
Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
Published on: September 22, 2023
Reducing recurrence rates in hiatal hernia repair: Results of a quality improvement study
Laura M Staunton1,2, Jarlath C Bolger1,2, Rakesh Ahmed1,2
1Department of General Surgery, St. James's Hospital, Dublin, Ireland.
Background:
Patient and procedure factors are considered in the decision-making process for surgical repair of hiatal hernias. Recurrence is multi-factorial and has been shown to be related to size, type, BMI and age.
Aims:
This study examined recurrence rates in a single institution, identified areas for improved surgical technique, and re-assessed recurrence following implantation of a quality improvement initiative.
Methods:
A retrospective review of patients undergoing hiatal hernia repair surgery between 2018 and 2022 was conducted. Demographics, pre-operative characteristics, intra-operative procedures and recurrence rates were reviewed.
Results:
Seventy-five patients from 2018 to 2020 and 34 patients from 2021 to 2022 were identified. The recurrence rate was 21% in 2018-2020, with 14% requiring a revisional procedure. Recurrence and re-operation were subsequently reduced to 6% in 2021 and 2022, which was statistically significant (p = 0.043). There was an increase in gastropexy from 21% to 41% following the review (p = 0.032), which was mainly reserved for large and giant hernias. Procedural and literature review, alongside gastropexy, can be attributed to recurrence rate reduction.
Conclusions:
It is important to educate patients on the likelihood and risk factors of recurrence. A comprehensive review of procedures and a quality improvement program in our facility for hiatal hernia repair is shown to reduce recurrence.
