488. RETROSPECTIVE MULTICENTER STUDY IN AUSTRALIA ON PARAESOPHAGEAL HERNIA REPAIR WITH GORE BIO-A® MESH: OUTCOMES, ASSOCIATION OF BODY MASS INDEX, RECURRENCE

Abstract Background Outcomes of paraesophageal hernia (PEH) repair with onlay bioabsorbable mesh (Bio-A® W.L. Gore & Associates,Inc.,Flagstaff) and body mass index (BMI) as risk factor for poor outcomes and recurrence have been previously published. This has not been evaluated in an Australian cohort. Methods We performed a retrospective observational cohort study on patients who underwent laparoscopic PEH repair with onlay Gore Bio-A® mesh between 01/01/2017 and 01/09/2023. Electronic health records from public and private hospitals based in New South Wales were accessed. Patients were grouped according to preoperative BMI (A:BMI < 25; B:BMI = 25–29.9; C:BMI = 30–34.9; D:BMI ≥ 35). Symptomatic outcomes, endoscopic recurrence and surgical reintervention rates were evaluated. Chi square tests were used to compare categorical variables. Results Of 459 patients, 71.5% were women. Mean age was 66.9 ± 13.8 years. Primary PEH repair was more common (n = 437;95.2%) than revisional (n = 22;4.8%) cases. The number of patients in BMI groups were: A:45(9.8%); B:195(42.5%); C:146(31.8%); D:73(15.9%). 97.8% patients had mean follow-up of 15.1 ± 2.4 months. At last follow-up, 89.7%, 4.5% and 5.8% had resolution, unchanged or recurrent symptoms respectively. Overall postoperative complication rate was (n = 30/449;6.6%), with (n = 23/280;8.2%) endoscopic recurrence and (n = 6/449;1.3%) surgical reintervention rate. No significant difference between BMI groups were observed for symptom resolution(p = 0.64), endoscopic recurrence(p = 0.35), complications(p = 0.11) or need for surgical intervention(p = 0.22). Conclusion Laparoscopic primary and revisional PEH repair with Gore Bio-A® mesh is safe and effective in a cohort of Australian patients with excellent short-term outcomes and acceptable symptomatic recurrence rate irrespective of BMI.