Eurasian Health Journal
ISSN 1694-8882 / e-ISSN 1694-8890
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Vol. 18, No. 2, 2026 / Pages 43-67

A comparative analysis of the outcomes of laparoscopic hiatal hernia repair within an ERAS programme

Bakytbek Osmonaliev*Zhyldyzkan KonurbaevaBaktybek AvasovBakyt AtakulovBektursun Tursunov

osmonalievbakytbek1982@gmail.com

Received 26.01.2026
Revised 01.05.2026
Accepted 29.05.2026

Abstract

The aim of the study was to conduct a comparative analysis of the outcomes of laparoscopic hiatal hernia repair performed within an ERAS programme and standard perioperative management. A single-centre comparative study was conducted, involving 100 patients with axial hiatal hernias, divided into two groups of 50 patients each. The ERAS principles were applied in the main group, whilst the control group received conventional management. All patients underwent laparoscopic hernia repair with dorsal cruroplasty and Nissen fundoplication. Clinical symptoms, the severity of pain, the incidence of complications and indicators of postoperative recovery were assessed. It was found that the use of the ERAS programme contributes to improved early postoperative outcomes: it reduces the length of hospital stay, accelerates the resumption of oral feeding and reduces the need for opioid analgesics. The implementation of the ERAS protocol resulted in a statistically significant reduction in the length of hospital stay to 2.8 ± 0.5 days, compared with 3.8 ± 1.4 days in the control group (p < 0.05). The time to resumption of oral intake in the ERAS group was reduced to 6.5 ± 1.2 hours, whereas with standard care this figure was 18.3 ± 4.5 hours (p < 0.01). The need for opioid analgesics in the ERAS group fell to 12% compared with 48% in the control group (p < 0.01). Intraoperative technical complications were recorded in 8% of patients in the main group and in 6% of the control group (p = 0.74), all of which were successfully resolved during the procedure. The incidence of early postoperative complications in the ERAS group was observed in only 3.8% of cases, which was significantly lower than in the control group, where the incidence of early complications was 11.2% (p < 0.05). The data obtained confirmed the efficacy and safety of implementing ERAS protocols in the laparoscopic hiatal hernia repair, which improves clinical outcomes and accelerates patient recovery

Keywords

gastroesophageal reflux; enhanced recovery after surgery; Nissen fundoplication; complications; quality of life

Suggested citation

APA Style
Osmonaliev, B., Konurbaeva, J., Avasov, B., Atakulov, B. & Tursunov, B. (2026). A comparative analysis of the outcomes of laparoscopic hiatal hernia repair within an ERAS programme. Eurasian Health Journal, 18(2), 43-67. https://doi.org/10.54890/1694-8882-2026-2-43
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Vancouver Style
Osmonaliev, B., Konurbaeva, J., Avasov, B., Atakulov, B., Tursunov, B.. A comparative analysis of the outcomes of laparoscopic hiatal hernia repair within an ERAS programme. Eurasian Health J. 2026;18(2):43-67. https://doi.org/10.54890/1694-8882-2026-2-43
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References

  1. Stasyshyn AR, Bochar VT, Pater YaZ, Fedchishyn NR. Surgical methods of treatment of hiatal hernias. Ukr J Clin Surg 2020;87(11–12):80–3. DOI: 10.26779/2522-1396.2020.11-12.80
  2. Osilli D, Loon MM, El Ibrahim F, Brar Y. Enhanced recovery after surgery in oesophagogastric procedures: A systematic review of clinical outcomes and postoperative recovery. Cureus. 2025;17(12):e99546. DOI: 10.7759/CUREUS.99546
  3. Hosein S, Carlson T, Flores L, Armijo PR, Oleynikov D. Minimally invasive approach to hiatal hernia repair is superior to open, even in the emergent setting: A large national database analysis. Surg Endosc. 2021;35(1):423–8. DOI: 10.1007/s00464-020-07404-y
  4. Sauro KM, Smith C, Ibadin S, Thomas A, Ganshorn H, Bakunda L, et al. Enhanced recovery after surgery guidelines and hospital length of stay, readmission, complications, and mortality: A meta-analysis of randomized clinical trials. JAMA Netw Open. 2024;7(6):e2417310. DOI: 10.1001/jamanetworkopen.2024.17310
  5. Parakonthun T, Gonggetyai G, Nampoolsuksan C, Suwatthanarak T, Tawantanakorn T, Swangsri J, et al. Higher compliance with the enhanced recovery after surgery protocol improves postoperative recovery and 6-month mortality in upper gastrointestinal surgery. Surg Pract Sci. 2024;19:100265. DOI: 10.1016/j.sipas.2024.100265
  6. Zhou B, Ji H, Liu Y, Chen Z, Zhang N, Cao X, et al. ERAS reduces postoperative hospital stay and complications after bariatric surgery: A retrospective cohort study. Med (Baltim). 2021;100(47):e27831. DOI: 10.1097/MD.0000000000027831
  7. Ioffe OY, Stetsenko OP, Markulan LY, Tarasov TA. Efficacy of the ERAS strategy in patients with type III-IV paraesophageal hernias. Gen Surg. 2024;(3):29–36. DOI: 10.30978/GS-2024-3-29
  8. Rollins KE, Varadhan KK, Dhatariya K, Lobo DN. Systematic review of the impact of HbA1c on outcomes following surgery in patients with diabetes mellitus. Clin Nutr. 2016;35(2):308–16. DOI: 10.1016/J.CLNU.2015.03.007
  9. Melloul E, Kelliher L. Enhanced recovery after surgery: Esophagectomy and gastrectomy. Dig Med Res. 2019;2:27. DOI: 10.21037/dmr.2019.08.08
  10. Feldheiser A, Aziz O, Baldini G, Cox BP, Fearon KC, Feldman LS, et al. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: Consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016;60(3):289–334. DOI: 10.1111/AAS.12651
  11. World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4. DOI: 10.1001/JAMA.2013.281053
  12. Mazzotta E, Villalobos-Hernandez EC, Harzman A, Christofi FL. Impact of minimal invasive robotic surgery on recovery from postoperative ileus and postoperative gastrointestinal tract dysfunction. Am J Biomed Sci Res. 2020;8(6):535–8. DOI: 10.34297/AJBSR.2020.08.001335
  13. Triantafyllou T, Olson MT, Theodorou D, Schizas D, Singhal S. Enhanced recovery pathways vs standard care pathways in esophageal cancer surgery: Systematic review and meta-analysis. Esophagus. 2020;17(2):100–12. DOI: 10.1007/S10388-020-00718-9
  14. Willcutts KF, Chung MC, Erenberg CL, Finn KL, Schirmer BD, Byham-Gray LD. Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: A systematic review and meta-analysis. Ann Surg. 2016;264(1):54–63. DOI: 10.1097/SLA.0000000000001644
  15. Parthsarthi PA, Agrawal AA, Parmar A, Manish M, Arora I, Kumari M. Enhanced recovery after surgery (ERAS) protocols: Impact on patient outcomes. Bioinformation. 2025;21(10):3599–602. DOI: 10.6026/973206300213599
  16. Roks DJ, Broeders JA, Baigrie RJ, Ooi GJ, Watson DI, Jamieson GG. Long-term symptom control of gastro-oesophageal reflux disease 12 years after laparoscopic Nissen or 180° anterior partial fundoplication in a randomized clinical trial. Br J Surg. 2017;104(7):852–6. DOI: 10.1002/BJS.10473
  17. Dong F, Li Y, Jin W, Qiu Z. Effect of ERAS pathway nursing on postoperative rehabilitation of patients undergoing gastrointestinal surgery: A meta-analysis. BMC Surg. 2025;25(1):239. DOI: 10.1186/S12893-025-02976-9
  18. Patil S, Cornett EM, Jesunathadas J, Belani K, Fox CJ, Kaye AD, et al. Implementing enhanced recovery pathways to improve surgical outcomes. J Anaesthesiol Clin Pharmacol. 2019;35(1):S24–8. DOI: 10.4103/JOACP.JOACP_36_18
  19. Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601–16. DOI: 10.1016/j.bpg.2007.12.007
  20. Nicholson A, Lowe MC, Parker J, Lewis SR, Alderson P, Smith AF. Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Br J Surg. 2014;101(3):172–88. doi: 10.1002/bjs.9394
  21. Noba L, Rodgers S, Chandler C, Balfour A, Hariharan D, Yip VS. Enhanced recovery after surgery (ERAS) reduces hospital costs and improve clinical outcomes in liver surgery: A systematic review and meta-analysis. J Gastrointest Surg. 2020;24(4):918–32. doi: 10.1007/s11605-019-04499-0