Short-Term Outcomes of Laparoscopic Hiatal Hernia Repair with Consecutive Transoral Incisionless Fundoplication: A Prospective Multicenter Cohort Study
Abstract
BACKGROUND
Laparoscopic hiatal hernia repair with consecutive transoral incisionless fundoplication (cTIF) offers a combined endoscopic surgical therapy for gastroesophageal reflux disease (GERD), but data integrating symptom response with objective physiologic outcomes remain limited.
STUDY DESIGN
Prospective multicenter registry of patients with BMI 50% reduction in GERD-Health Related Quality of Life (GERD-HRQL) score within 12 months. Secondary endpoints included reflux symptom index (RSI) normalization, esophageal acid exposure normalization by pH testing or discontinued/rare proton pump inhibitor (PPI) use, patient satisfaction, and adverse events.
RESULTS
Among 188 patients (mean hiatal hernia 3 cm), clinical success was achieved in 92%. GERD-HRQL improvement occurred in 90%, and RSI normalized in 84%. Daily PPI use was discontinued in 84%. Objective testing demonstrated normalization of esophageal acid exposure in 84% and DeMeester score in 85%. Patient satisfaction increased from 6% preoperatively to 75% postoperatively. Median length of stay was 23 hours [IQR 16-25]. Three serious adverse events occurred (1.6%).
CONCLUSIONS
cTIF achieves high rates of symptom improvement, PPI discontinuation, and normalization of esophageal acid exposure with low morbidity, supporting its role as an effective strategy for selected patients with GERD.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 188 participants or records.
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