Journal of the American College of Surgeons · 2026
Short-Term Outcomes of Laparoscopic Hiatal Hernia Repair with Consecutive Transoral Incisionless Fundoplication: A Prospective Multicenter Cohort Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kolb Jennifer M, Canto Marcia Irene, Parker Brett, Murray Michael, Brewer Gutierrez Olaya I, Sharaiha Reem Z, Abu-Dayyeh Barham K, Janu Peter, Chang Kenneth J, Nguyen Ninh T
Аннотация
BACKGROUND: Laparoscopic hiatal hernia repair with consecutive transoral incisionless fundoplication (cTIF) offers a combined endoscopic surgical therapy for GERD, but data integrating symptom response with objective physiologic outcomes remain limited.
STUDY DESIGN: Prospective multicenter registry of patients with BMI less than 35 kg/m 2 , hiatal hernia less than 5 cm, confirmed GERD, and no earlier antireflux intervention undergoing cTIF across 8 sites. The primary endpoint was clinical success, defined as >50% reduction in GERD-Health-Related Quality-of-Life score within 12 months. Secondary endpoints included normalization of the Reflux Symptom Index, normalization of esophageal acid exposure by pH testing, discontinuation or rare use of proton pump inhibitor (PPI), patient satisfaction, and adverse events.
RESULTS: Among 188 patients (mean hiatal hernia size 3 cm), clinical success was achieved in 90% of patients. Improvement in GERD-Health-Related Quality-of-Life score occurred in 90% of patients, and Reflux Symptom Index normalized in 84% of patients. Daily PPI use was discontinued in 84% of patients. Objective testing demonstrated normalization of esophageal acid exposure in 84% of patients and the DeMeester score in 85% of patients. Patient satisfaction increased from 6% preoperatively to 75% postoperatively. The median length of stay was 23 hours (interquartile range 16 to 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.
STUDY DESIGN: Prospective multicenter registry of patients with BMI less than 35 kg/m 2 , hiatal hernia less than 5 cm, confirmed GERD, and no earlier antireflux intervention undergoing cTIF across 8 sites. The primary endpoint was clinical success, defined as >50% reduction in GERD-Health-Related Quality-of-Life score within 12 months. Secondary endpoints included normalization of the Reflux Symptom Index, normalization of esophageal acid exposure by pH testing, discontinuation or rare use of proton pump inhibitor (PPI), patient satisfaction, and adverse events.
RESULTS: Among 188 patients (mean hiatal hernia size 3 cm), clinical success was achieved in 90% of patients. Improvement in GERD-Health-Related Quality-of-Life score occurred in 90% of patients, and Reflux Symptom Index normalized in 84% of patients. Daily PPI use was discontinued in 84% of patients. Objective testing demonstrated normalization of esophageal acid exposure in 84% of patients and the DeMeester score in 85% of patients. Patient satisfaction increased from 6% preoperatively to 75% postoperatively. The median length of stay was 23 hours (interquartile range 16 to 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.