399. CURRENT PRACTICE IN ANTIREFLUX AND HIATAL HERNIA SURGERY: EXPLORATION OF THE BELGIAN FIELD

In Belgium no publicly available information exists on the spread, quality, results nor follow-up of antireflux and hiatal hernia surgery, in contrast to the recently centralized esophageal cancer surgery. However, in some countries a plea is rising to perform this benign esophageal surgery in high volume centers. The aim of this study was to create a snap shot of the current practice in Belgium. An online questionnaire was distributed among all members of the Royal Belgian Society for Surgery in autumn 2021. A total of 33 questions spread over four sections were asked, covering demographics, current practice (case load, case mix, indications for surgery, preoperative workup, patient information, average length of stay, follow up, quality of life (QOL)), operative techniques (approach, type of procedure, crural reinforcement) and future thoughts (opinion on the future of antireflux and hiatal hernia surgery in Belgium). Twenty-four surgeons completed the questionnaire. Surgical indications are discussed multidisciplinary and based on guidelines in 67%. Workup includes endoscopy, pH-monitoring and manometry in 100%. Barium swallow, impedance and gastric emptying tests were added in respectively 83%, 42% and 13%. Symptom or QOL scores were used in 17%. 81% are performed as primary surgery, 18% redo surgery and 1% resections. Laparoscopic procedures are reported in 99%: Nissen(−Rosetti) 79%, Toupet/Lind 15%, partial gastrectomy 5% and Collis gastroplasty 1%. Discharge is planned on POD1 in 42% and on POD2 in 54%. 50% performs follow-up