[Collis-Nissen esophagogastroplasty for hiatal hernia and short esophagus]

To evaluate the immediate and long-term results of Collis-Nissen esophagogastroplasty in patients with hiatal hernias, recurrent hiatal hernias and short esophagus.

There were 486 patients with hiatal hernia between 2014 and 2024. In 54 (11.1%) patients, hiatal hernia was characterized by acquired short esophagus. Of these, 45 patients had primary hernia, 9 patients - recurrent hiatal hernia after previous surgery in other hospitals. Mean age of patients was 52±12 years (range 24-75). The men-to-women ratio was 18:36. Heartburn was noted in 35 patients (64.8%), dysphagia, belching and periodic chest pain - in 14 patients (25.9%), cough and shortness of breath - in 5 patients (9.2%). Reflux esophagitis was diagnosed in 23 (42.5%) patients according to EGDS data; 43 (79.6%) patients were forced to take proton pump inhibitors.

All 54 patients underwent laparoscopic Collis-Nissen esophagogastroplasty with hardware resection of the gastric floor and formation of a gastric tube (neo-esophagus). Mean surgery time was 3 (2-4.5) hours, length of hospital-stay - 7 (5-15) days. There were no intraoperative complications. Postoperative complication was noted in 1 (1.8%) case (neo-esophagus suture failure). Erosive reflux esophagitis in 6 months after surgery was observed in 4 (7.4%) patients. After 12 months, these patients showed no signs of esophagitis. Recurrent hiatal hernia after 6 years was detected in 1 (1.8%) patient. According to GERD - HRQL questionnaire, 39 (92.8%) out of 42 surveyed patients had no signs of gastroesophageal reflux disease.

The authors demonstrate immediate and long-term results of Collis-Nissen esophagastroplasty for primary / recurrent hiatal hernia complicated by short esophagus. Our results demonstrate effectiveness and safety of this technique of esophagogastroplasty for short esophagus and lower incidence of recurrent hiatal hernia.