To investigate the recurrence rate and its risk factors of laparoscopic esophageal hiatal hernia repair.

Clinical data of 44 patients with esophageal hiatal hernia who underwent laparoscopic hiatal hernia repair in Hospital of Inner Mongolia Medical University from January 2017 to December 2019 were sampled by stratified cluster sampling. The information related to the recurrence of postoperative esophageal hiatal hernia was registered with a unified questionnaire, and the risk factors of postoperative recurrence in patients with different characteristics were analyzed.

There was no loss of follow-up and refusal of follow-up in 44 patients. There were 16 cases of hiatal hernia recurrence (including symptomatic recurrence and imaging recurrence). The recurrence rate was 36.36%. The recurrence mostly occurred within 2 years after operation. There was basically no recurrence after 2 years. Fundoplication, postoperative cough, postoperative dysphagia, postoperative acid reflux, hole defect diameter, postoperative hospital stay, postoperative esophageal pressure and postoperative acid reflux DeMeester score were independent impact factors of esophageal hiatal hernia recurrence (all P<0.05). The statistically significant variable indexes (fundoplication, hiatal defect diameter, postoperative esophageal pressure, postoperative acid reflux DeMeester score) and their regression coefficients in the multivariate equation were selected to establish the multivariate regression equation for predicting the recurrence model of esophageal hiatal hernia repair, and the multivariate logistic regression model was established. The standard error of the model in diagnosing the recurrence after esophageal hiatal hernia repair was 0.052. The AUC (95% CI) was 0.845 (0.623-0.987).

The main impact factors of recurrence after esophageal hiatal hernia repair include gastric fundoplication, hiatal defect diameter, postoperative esophageal pressure and postoperative acid reflux DeMeester score. Clinical treatment should be selected and observed according to the individual situation of patients to reduce the recurrence rate of esophageal hiatal hernia.