Society for Surgery of the Alimentary Tract
SSAT Home SSAT Home Past & Future Meetings Past & Future Meetings

Back to 2023 Abstracts


HISTORY OF LUNG TRANSPLANTATION IS NO LONGER A RISK FACTOR FOR POOR SHORT-TERM OUTCOMES AFTER ROBOT-ASSISTED HIATAL HERNIA OR GASTROESOPHAGEAL REFLUX SURGERY
Rebecca E. Wu*, Valeria Robayo, Duc T. Nguyen, Edward Y. Chan, Ray Chihara, Katherine D. Gray, Howard J. Huang, Edward A. Graviss, Min P. Kim
Houston Methodist Hospital, Houston, TX

Introduction
Laparoscopic fundoplication in patients with a history of lung transplant has an average length of stay (LOS) of 3 days with a 30-day readmission rate of 25%, which is significantly worse compared to the non-lung transplant population. We investigated if lung transplantation was still a risk factor for poor short-term outcomes in a practice that exclusively uses the robot for hiatal hernia/GERD surgeries.

Methods
We performed a single-center retrospective analyses of the Society of Thoracic Surgery (STS) database for patients who underwent elective hiatal hernia/GERD procedures from 1/5/2018 to 2/6/2021. We identified patient and surgical characteristics, morbidity, LOS, 30-day readmission and mortality. Analysis was conducted using Chi-square and Wilcoxon rank-sum tests, univariable linear regression, and bivariate analysis. A p-value below 0.05 was considered significant.

Results
Among 386 patients who underwent barrier creation, 43 patients had previously undergone a lung transplant, either bilateral (n=28) or single (n=14). The hiatal hernia/GERD procedure was performed for the lung transplant population on an average of 2.5 years post-transplant (SD +/- 2.5). All lung transplant patients underwent robotic-assisted laparoscopic hiatal hernia/GERD surgery. There was no significant difference in post-operative complications (9.3% vs. 5.2%, p=0.29, Figure 1A), median hospital LOS (1 vs. 1 day, p=0.27, Figure 1B), 30-day readmission (7.0% vs. 5.0%, p=0.48, Figure 1C), or 30-day all-cause mortality (0% vs. 0.6%, p=1.0) between lung transplant and non-lung transplant patients. Univariate analysis showed older age (p=0.03), opioid dependence (p=0.02), neurocognitive dysfunction (p<0.001), and dependent functional status (p=0.02) were associated with all post-operative complications. However, lung transplantation was not associated with increased risk of postoperative complications (p=0.28).

Discussion
In this cohort of patients who underwent robot-assisted laparoscopic hiatal hernia / GERD surgery, we found no difference in short-term outcomes between lung transplant and non-lung transplant patients. Robot-assisted surgery may provide improved outcomes for high-risk surgical patients.



Back to 2023 Abstracts