Shankar I Logarajah1, Jashwanth Karumuri1, David Ahle1, Michael Jureller1, Maitham Moslim1, Houssam Osman1,2, D Rohan Jeyarajah3,4. 1. Department of Surgery, Methodist Richardson Medical Center, 2805 East President George Bush Highway, Richardson, TX, USA. 2. Department of Surgery, TCU School of Medicine, 3430 Camp Bowie Boulevard, Fort Worth, TX, USA. 3. Department of Surgery, Methodist Richardson Medical Center, 2805 East President George Bush Highway, Richardson, TX, USA. rohanjeyarajah@gmail.com. 4. Department of Surgery, TCU School of Medicine, 3430 Camp Bowie Boulevard, Fort Worth, TX, USA. rohanjeyarajah@gmail.com.
Abstract
BACKGROUND: Primary repair failure rates for hiatal hernias (HH) can reach up to 40%, this is especially high in the morbidly obese patient. There is no clear data on how to manage this patient subset. This paper evaluates the efficacy of Roux-N-Y Gastrojejunostomy (RNY GJ) for treatment of symptomatic HH. METHODS: A retrospective analysis of all patients who received a Roux-en-Y Gastrojejunostomy (RNY GJ) for HH at our institution between January 2016 and January 2021 was performed. Patient demographics, symptoms, and post-operative outcomes were recorded and univariate analysis was performed between preoperative and postoperative symptoms. RESULTS: Thirty-seven patients with a mean age of 56.9 years (SD 11.8) underwent RNY GJ. Patients were mostly female (81.1%) with a mean BMI of 36.8 (SD 8.4). An 78.4% reduction in symptoms of either heartburn, dysphagia, or regurgitation was noted at follow up (p < 0.001). CONCLUSIONS: RNY GJ represents a safe procedure for morbidly obese patients with hiatal hernias with no mortalities amongst our patient cohort along with a significant reduction in pre-operative symptoms and no symptomatic recurrences. RNY GJ should be considered as the operation of choice for repair for this patient population.
BACKGROUND: Primary repair failure rates for hiatal hernias (HH) can reach up to 40%, this is especially high in the morbidly obese patient. There is no clear data on how to manage this patient subset. This paper evaluates the efficacy of Roux-N-Y Gastrojejunostomy (RNY GJ) for treatment of symptomatic HH. METHODS: A retrospective analysis of all patients who received a Roux-en-Y Gastrojejunostomy (RNY GJ) for HH at our institution between January 2016 and January 2021 was performed. Patient demographics, symptoms, and post-operative outcomes were recorded and univariate analysis was performed between preoperative and postoperative symptoms. RESULTS: Thirty-seven patients with a mean age of 56.9 years (SD 11.8) underwent RNY GJ. Patients were mostly female (81.1%) with a mean BMI of 36.8 (SD 8.4). An 78.4% reduction in symptoms of either heartburn, dysphagia, or regurgitation was noted at follow up (p < 0.001). CONCLUSIONS: RNY GJ represents a safe procedure for morbidly obese patients with hiatal hernias with no mortalities amongst our patient cohort along with a significant reduction in pre-operative symptoms and no symptomatic recurrences. RNY GJ should be considered as the operation of choice for repair for this patient population.
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