Abstract：
BACKGROUND: Adherence to preoperative weight loss recommendations may serve as a surrogate for the level of engagement in hiatal hernia (HH) patients. This study aims to evaluate the relationship between achieving preoperative weight loss goals and outcomes after HH repair.
METHODS: A retrospective review of 235 patients undergoing laparoscopic HH repair at a single institution was performed. Patients were grouped based on the percentage of weight loss goal achieved. Low achievement was defined as the bottom quartile of goal achievement (≤75%); high achievement was defined as the top quartile (≥140%). Baseline characteristics, clinical outcomes, and patient reported outcomes (PROMs) were compared between groups.
RESULTS: 131/235 (55.7%) achieved their weight loss goal. No differences in baseline characteristics or clinical outcomes were observed between the low and high achievement groups. While both groups experienced improvements in PROMs postoperatively, patients in the high achievement group demonstrated significantly lower symptom burden at one-month postoperatively. Further, high-achievement patients were more likely to experience complete resolution of common HH symptoms at one-month postoperatively, including no difficulty swallowing food, no breathing difficulties or choking episodes, no choking when eating food, no choking when drinking liquid, and no regurgitation of food or liquid.
CONCLUSIONS: In patients undergoing laparoscopic HH repair, patients achieving their preoperative weight loss goals experienced less overall symptom burden and lower prevalence of common symptoms one-month postoperatively than those with low levels of goal achievement. These results demonstrate that patients can take an active role in improving their own surgical outcomes and health status.
METHODS: A retrospective review of 235 patients undergoing laparoscopic HH repair at a single institution was performed. Patients were grouped based on the percentage of weight loss goal achieved. Low achievement was defined as the bottom quartile of goal achievement (≤75%); high achievement was defined as the top quartile (≥140%). Baseline characteristics, clinical outcomes, and patient reported outcomes (PROMs) were compared between groups.
RESULTS: 131/235 (55.7%) achieved their weight loss goal. No differences in baseline characteristics or clinical outcomes were observed between the low and high achievement groups. While both groups experienced improvements in PROMs postoperatively, patients in the high achievement group demonstrated significantly lower symptom burden at one-month postoperatively. Further, high-achievement patients were more likely to experience complete resolution of common HH symptoms at one-month postoperatively, including no difficulty swallowing food, no breathing difficulties or choking episodes, no choking when eating food, no choking when drinking liquid, and no regurgitation of food or liquid.
CONCLUSIONS: In patients undergoing laparoscopic HH repair, patients achieving their preoperative weight loss goals experienced less overall symptom burden and lower prevalence of common symptoms one-month postoperatively than those with low levels of goal achievement. These results demonstrate that patients can take an active role in improving their own surgical outcomes and health status.
摘要：
背景：遵守术前减重建议可作为食管裂孔疝（HH）患者参与程度的替代指标。本研究旨在评估HH修复后实现术前体重减轻目标与结果之间的关系。
方法：对单家机构接受腹腔镜HH修复的235例患者进行回顾性分析。根据达到的体重减轻目标的百分比对患者进行分组。低成就定义为目标成就的底部四分位数（≤75％）；高成就定义为顶部四分位数（≥140％）。基线特征，临床结果，和患者报告的结果（PROM）进行了组间比较。
结果：131/235（55.7％）达到了减肥目标。在低成就组和高成就组之间没有观察到基线特征或临床结果的差异。虽然两组术后PROM都有改善，高成就组患者在术后1个月时症状负担显著降低.Further,高成就患者在术后1个月更有可能经历常见HH症状的完全缓解，包括吞下食物没有困难，没有呼吸困难或窒息发作，吃食物时没有窒息，喝液体时没有窒息，没有食物或液体返流。
结论：在接受腹腔镜HH修补术的患者中，与目标完成水平较低的患者相比,达到术前减重目标的患者术后1个月的总体症状负担较少,常见症状发生率较低.这些结果表明，患者可以在改善自己的手术结果和健康状况方面发挥积极作用。
方法：对单家机构接受腹腔镜HH修复的235例患者进行回顾性分析。根据达到的体重减轻目标的百分比对患者进行分组。低成就定义为目标成就的底部四分位数（≤75％）；高成就定义为顶部四分位数（≥140％）。基线特征，临床结果，和患者报告的结果（PROM）进行了组间比较。
结果：131/235（55.7％）达到了减肥目标。在低成就组和高成就组之间没有观察到基线特征或临床结果的差异。虽然两组术后PROM都有改善，高成就组患者在术后1个月时症状负担显著降低.Further,高成就患者在术后1个月更有可能经历常见HH症状的完全缓解，包括吞下食物没有困难，没有呼吸困难或窒息发作，吃食物时没有窒息，喝液体时没有窒息，没有食物或液体返流。
结论：在接受腹腔镜HH修补术的患者中，与目标完成水平较低的患者相比,达到术前减重目标的患者术后1个月的总体症状负担较少,常见症状发生率较低.这些结果表明，患者可以在改善自己的手术结果和健康状况方面发挥积极作用。
