Short Term Outcome of Laparoscopic Mesh Cruroplasty in Hiatus Hernia

Khalil, Osama M. H.; Ibrahim, Amr; Abdelaal El sied, Hisham Abdelhamid; Fathy, Karim M

doi:10.21608/zumj.2025.379259.3928

	Short Term Outcome of Laparoscopic Mesh Cruroplasty in Hiatus Hernia
Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 01 June 2025
Document Type: Original Article
DOI: 10.21608/zumj.2025.379259.3928
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Authors
Osama M. H. Khalil ¹; Amr Ibrahim¹; Hisham Abdelhamid Abdelaal El sied ²; Karim M Fathy³
¹Professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt
²Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt
³Lecturer of General Surgery, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: Hiatus hernia (HH) repair remains a debated and technically demanding procedure. While primary suture repair often yields good outcomes, recurrence rates can reach up to 33%, especially in large paraesophageal hiatal hernias (LPHH). This study aimed to assess the short-term outcomes of laparoscopic mesh cruroplasty in hiatus hernia. Methods: A prospective clinical study was conducted at the General Surgery Department, Zagazig University Hospital, involving 12 patients with symptomatic HH. Most patients were male (66.7%), with a median age of 50 years (range 38–64). Diagnosis was established using upper GI endoscopy, contrast-enhanced CT, manometry, and 24-hour pH monitoring. Results: The most common presenting symptoms were heartburn (100%) and regurgitation (75%), followed by chest pain and dysphagia (25% each). Hiatus hernia type III was identified in 66.7% of cases. Operative time ranged from 100 to 160 minutes, and hospital stay varied between 1 and 14 days, with a mean of 3.25 days. Postoperative pain scores ranged from 2 to 8, with a mean of 4.67. Intraoperative complications occurred in 33.3% of cases, while early postoperative complications were reported in 83.3%. At 6-month follow-up, symptoms including heartburn, regurgitation, epigastric pain, and gas bloat were present in 8.3% of patients, with no statistically significant difference in postoperative complications between 3 and 6 months. Conclusion: Laparoscopic mesh hiatal hernioplasty improves symptoms, enhances quality of life, and lowers recurrence rates. However, current evidence remains insufficient to recommend routine mesh cruroplasty for all HH cases.
Keywords
Hiatus hernia; Laparoscopic; Mesh Cruroplasty


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