Effect of body mass index on surgical outcomes of laparoscopic surgery for esophageal hiatal hernia: A propensity score matching study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 WANG Yifan , JIN Jian , LI Aijian , LIU Yang

Department of Thoracic Surgery, The Affiliated Hospital of Chengdu University, Chengdu, 610081, P.R.China;

Corresponding author：

WANG Yifan, Email: wangfan1108@163.com

Keywords：

Esophageal hiatal hernia; laparoscopic hiatal hernioraphy; fundoplication; body mass index; propensity score matching

DOI：

10.7507/1007-4848.201905028

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Objective To explore the effect of body mass index (BMI) on the outcomes of laparoscopic surgery for esophageal hiatal hernia.Methods We divided the patients who underwent hiatal hernioraphy and fundoplication surgery in our hospital between July 2013 and June 2018 into two groups according to the BMI: a group A, BMI ≥24 kg/m², 77 patients, 41 males, 36 females, with an average age of 42 years; a group B: BMI<24 kg/m², 63 patients, 38 males, 25 females, with an average age of 67 years, and the age, gender, type of hiatal hernia, score of subjective feeling of symptoms, level of reflux esophagitis were analyzed with the propensity score matching method. Fifty one patients were successfully matched in each group, and the curative effect of surgery was compared between the two groups.Results There was no statistical difference in the type of surgery, intraoperative complications, postoperative complications, and hospital stay between the two groups (P>0.05). The operative time of the group A was significantly longer than that of the group B (P=0.023). There was no statistical difference between the two groups in postoperative recurrence (P=0.741).Conclusion The operative time in overweight patients is significantly longer than that in the non-overweight patients, but it has no effect on the surgical outcomes and complications.

Citation： WANG Yifan, JIN Jian, LI Aijian, LIU Yang. Effect of body mass index on surgical outcomes of laparoscopic surgery for esophageal hiatal hernia: A propensity score matching study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 308-311. doi: 10.7507/1007-4848.201905028 Copy

1.	Schauer PR, Ikramuddin S, McLaughlin RH, et al. Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg, 1998, 176(6): 659-665.
2.	Oelschlager BK, Pellegrini CA. Paraesophageal hernias: open, laparoscopic, or thoracic repair? Chest Surg Clin N Am, 2001, 11(3): 589-603.
3.	Akimoto S, Nandipati KC, Kapoor H, et al. Association of body mass index (BMI) with patterns of fundoplication failure: insights gained. J Gastrointest Surg, 2015, 19(11): 1943-1948.
4.	Tekin K, Toydemir T, Yerdel MA. Is laparoscopic antireflux surgery safe and effective in obese patients? Surg Endosc, 2012, 26(1): 86-95.
5.	Yang H, Watson DI, Lally CJ, et al. Randomized trial of division versus non-division of the short gastric vessels during laparoscopic Nissen fundoplication—10 year outcomes. Ann Surg, 2018, 247: 38-42.
6.	Omura N, Kashiwagi H, Yano F, et al. Prediction of recurrence after laparoscopic fundoplication for erosive reflux esophagitis based on anatomy-function-pathology (AFP) classification. Surg Endosc, 2007, 21(3): 427-430.
7.	Omura N, Aoki T, Kashiwagi H, et al. An index to predict outcome of surgery for reflux esophagitis based on the AFP classification. Surg Today, 1995, 25(10): 861-866.
8.	Broeders JA, Broeders EA, Watson DI, et al. Objective outcomes 14 years after laparoscopic anterior 180-degree partial versus nissen fundoplication: results from a randomized trial. Ann Surg, 2013, 258(2): 233-239.
9.	Engström C, Cai W, Irvine T, et al. Twenty years of experience with laparoscopic antireflux surgery. Br J Surg, 2012, 99(10): 1415-1421.
10.	Aly A, Munt J, Jami eson GG, et al. Laparoscopic repair of large hiatal hernias. Br J Surg, 2005, 92(5): 648-653.
11.	Luketina RR, Koch OO, Köhler G, et al. Obesity does not affect the outcome of laparoscopic antireflux surgery. Surg Endosc, 2015, 29(6): 1327-1333.
12.	Simorov A, Ranade A, Jones R, et al. Long-term patient outcomes after laparoscopic anti-reflux procedures. J Gastrointest Surg, 2014, 18(1): 157-162.
13.	Chisholm JA, Jamieson GG, Lally CJ, et al. The effect of obesity on the outcome of laparoscopic antireflux surgery. J Gastrointest Surg, 2009, 13(6): 1064-1070.
14.	Anvari M, Bamehriz F. Outcome of laparoscopic Nissen fundoplication in patients with body mass index >or=35. Surg Endosc, 2006, 20(2): 230-234.
15.	Mariette C, Boutillier J, Arnaud N, et al. Outcome of day-case laparoscopic fundoplication for gastro-esophageal reflux disease. J Visc Surg, 2011, 148(1): 50-53.
16.	Kelly ME, Gallagher TK, Smith MJ, et al. Day-case laparoscopic Nissen fundoplication: a default pathway or is selection the key? J Laparoendosc Adv Surg Tech A, 2012, 22(9): 859-863.
17.	Colavita PD, Belyansky I, Walters AL, et al. Nationwide inpatient sample: have antireflux procedures undergone regionalization? J Gastrointest Surg, 2013, 17(1): 6-13.

1. Schauer PR, Ikramuddin S, McLaughlin RH, et al. Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg, 1998, 176(6): 659-665.
2. Oelschlager BK, Pellegrini CA. Paraesophageal hernias: open, laparoscopic, or thoracic repair? Chest Surg Clin N Am, 2001, 11(3): 589-603.
3. Akimoto S, Nandipati KC, Kapoor H, et al. Association of body mass index (BMI) with patterns of fundoplication failure: insights gained. J Gastrointest Surg, 2015, 19(11): 1943-1948.
4. Tekin K, Toydemir T, Yerdel MA. Is laparoscopic antireflux surgery safe and effective in obese patients? Surg Endosc, 2012, 26(1): 86-95.
5. Yang H, Watson DI, Lally CJ, et al. Randomized trial of division versus non-division of the short gastric vessels during laparoscopic Nissen fundoplication—10 year outcomes. Ann Surg, 2018, 247: 38-42.
6. Omura N, Kashiwagi H, Yano F, et al. Prediction of recurrence after laparoscopic fundoplication for erosive reflux esophagitis based on anatomy-function-pathology (AFP) classification. Surg Endosc, 2007, 21(3): 427-430.
7. Omura N, Aoki T, Kashiwagi H, et al. An index to predict outcome of surgery for reflux esophagitis based on the AFP classification. Surg Today, 1995, 25(10): 861-866.
8. Broeders JA, Broeders EA, Watson DI, et al. Objective outcomes 14 years after laparoscopic anterior 180-degree partial versus nissen fundoplication: results from a randomized trial. Ann Surg, 2013, 258(2): 233-239.
9. Engström C, Cai W, Irvine T, et al. Twenty years of experience with laparoscopic antireflux surgery. Br J Surg, 2012, 99(10): 1415-1421.
10. Aly A, Munt J, Jami eson GG, et al. Laparoscopic repair of large hiatal hernias. Br J Surg, 2005, 92(5): 648-653.
11. Luketina RR, Koch OO, Köhler G, et al. Obesity does not affect the outcome of laparoscopic antireflux surgery. Surg Endosc, 2015, 29(6): 1327-1333.
12. Simorov A, Ranade A, Jones R, et al. Long-term patient outcomes after laparoscopic anti-reflux procedures. J Gastrointest Surg, 2014, 18(1): 157-162.
13. Chisholm JA, Jamieson GG, Lally CJ, et al. The effect of obesity on the outcome of laparoscopic antireflux surgery. J Gastrointest Surg, 2009, 13(6): 1064-1070.
14. Anvari M, Bamehriz F. Outcome of laparoscopic Nissen fundoplication in patients with body mass index >or=35. Surg Endosc, 2006, 20(2): 230-234.
15. Mariette C, Boutillier J, Arnaud N, et al. Outcome of day-case laparoscopic fundoplication for gastro-esophageal reflux disease. J Visc Surg, 2011, 148(1): 50-53.
16. Kelly ME, Gallagher TK, Smith MJ, et al. Day-case laparoscopic Nissen fundoplication: a default pathway or is selection the key? J Laparoendosc Adv Surg Tech A, 2012, 22(9): 859-863.
17. Colavita PD, Belyansky I, Walters AL, et al. Nationwide inpatient sample: have antireflux procedures undergone regionalization? J Gastrointest Surg, 2013, 17(1): 6-13.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of body mass index on surgical outcomes of laparoscopic surgery for esophageal hiatal hernia: A propensity score matching study

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