Comparison of outcomes in dogs undergoing hiatal hernia repair with and without use of a gastropexy: 41 cases (2012-2022)

Objectives: To determine the difference in complication rate, gastrointestinal grade and requirement for ongoing medical and/or surgical management following hiatal hernia repair in dogs with and without gastropexy. Materials and methods: Clinical records were reviewed retrospectively for dogs that had undergone surgical hiatal hernia repair at two veterinary referral centres between April 2012 and March 2022. Pre-operative grading of gastrointestinal signs and brachycephalic obstructive airway syndrome was performed. All dogs had an oesophagopexy and phrenoplasty. Referring primary veterinary practices and clients were contacted to obtain follow-up information. Fisher's exact tests and Mann Whitney tests were used to assess pre- and intra-operative similarities between groups. Wilcoxon signed rank tests were used to determine the changes in gastrointestinal grade at short- (<6 months) and long-term (>6 months) follow-up. Results: Forty-one dogs which underwent oesophagopexy and phrenoplasty were included. Fifteen dogs had no gastropexy performed and 26 dogs had left-sided gastropexy performed. Dogs that underwent gastropexy (n=8, 29%, 95% CI: 13 to 51%) were significantly more likely to require further surgery related to the initial surgery or persistence of gastrointestinal signs compared to dogs that had no gastropexy (n=0, 0%, 95% CI: 0 to 18%) . This difference was not significant when dogs which had further surgery to address brachycephalic obstructive airway syndrome were excluded. Gastrointestinal grade significantly improved for both groups at both short- and long-term follow-up. There was no significant difference in overall complication rate, gastrointestinal grade or requirement for further medical treatment between groups. Clinical significance: A left-sided gastropexy is not required for successful surgical repair of hiatal hernia in dogs provided oesophagopexy and phrenoplasty are performed.