RESUMO
BACKGROUND: Recurrent hiatal hernia remains a challenge. METHODS: For initial repairs at our center: patients with 1 repair were compared to those who required reoperation for symptomatic recurrence. Subsequently, patients who had 1 repair at our center were compared to all patients who required reoperation (including initial repair at another center). RESULTS: There were 401 repairs: 308 primary repairs at our center and 93 reoperations, 287/308 (93%) required 1 repair and 21/308 (7%) required reoperation. Comparing 1 repair versus 21 reoperations, risk factors were abdominoplasty odds ratioâ¯=â¯32.0 (4.1-250.6), Pâ¯<â¯.001, postoperative lifting/vomiting odds ratioâ¯=â¯11.6 (3.2-42.1), Pâ¯<â¯.0002, tubal ligation odds ratioâ¯=â¯4.9 (1.1-22.6), Pâ¯<â¯.04 and height < 160â¯cm odds ratioâ¯=â¯3.9 (1.1-13.3) Pâ¯<â¯0.03. Comparing 287 with 1 repair versus all 93 reoperations, risk factors were post-operative vomiting odds ratioâ¯=â¯22.7 (2.3-218.0), Pâ¯<â¯.007, abdominoplasty odds ratioâ¯=â¯5.6 (1.0-31.4), Pâ¯<â¯.0495, post-operative lifting odds ratioâ¯=â¯5.4 (2.2-12.9), Pâ¯<â¯.0002, age < 52 odds ratioâ¯=â¯3.6 (1.8-7.3), Pâ¯<â¯.0003, tubal ligation odds ratioâ¯=â¯3.2 (1.2-8.7), Pâ¯<â¯0.019 and height < 160â¯cm odds ratioâ¯=â¯3.0 (1.5-6.1), Pâ¯<â¯0.003. CONCLUSIONS: Younger age, shorter stature, heavy lifting or vomiting after surgery, abdominoplasty and tubal ligation are risk factors associated with symptomatic recurrence requiring reoperation.