Abstract

Background: Hiatal hernia is a common condition with chronic symptoms that may affect the quality of life, usually with delayed diagnosis due to a wide spectrum of symptoms that may similar with other conditions. Few studies have been done about hiatal hernia in the last few years, so I will made this research to evaluate hiatal hernia symptoms and the efficacy of laparoscopic repair in our country. Objectives: to evaluate the outcomes of post-laparoscopic hiatal hernia repair regarding typical and atypical clinical manifestations. Patients and method: The prospective cohort study for a total of 275 patients who were operated on between 17 March 2021 and 14 July 2023 by laparoscopic approach of hiatal hernia repair. All the data was retrieved from hospital information systems of AL-IRAQI Center private hospital, AL-GADEER private hospital in AL-NAJAF city, direct communication or phone calls of the patients. Result: This study evaluates the demographic characteristics, clinical manifestations, diagnostic findings, and surgical outcomes of patients with GERD-related hiatal hernia, dividing them into typical and atypical presentation groups. The study revealed no significant gender differences between the groups; however, a notable age difference was observed, with the typical group being younger (median age 28.4 years) compared to the atypical group (median age 49 years). Typical symptoms such as heartburn and regurgitation were prevalent, while atypical symptoms included chronic cough, chronic laryngitis, asthma symptoms, and dental erosion. Diagnostic evaluations indicated that atypical cases exhibited more severe esophageal motility issues and complex hernia types. Surgical outcomes demonstrated that atypical cases required more complex and longer operative procedures. Immediate postoperative complications, particularly dysphagia, were common but generally resolved within six months. The study underscored the efficacy of surgical intervention, with significant improvements in both typical and atypical symptoms over time. Notably, the resolution rates for typical and atypical symptoms were 91.7% and 45.9%, respectively, indicating the need for tailored postoperative care. These findings highlight the importance of recognizing the diverse clinical presentations of hiatal hernia to ensure timely diagnosis and effective management. Conclusions: The study emphasizes the diverse clinical presentations of GERD-related hiatal hernia and underscores the efficacy of the surgical intervention in improving symptoms. It highlights the need for recognizing both typical and atypical symptoms to facilitate timely diagnosis and appropriate management strategies.