Most patients with an uncomplicated sliding hiatal hernia will have adequate relief of symptoms (but not cure) with medical therapy.[6]Roman S, Kahrilas PJ. The diagnosis and management of hiatus hernia. BMJ. 2014 Oct 23;349:g6154.
http://www.ncbi.nlm.nih.gov/pubmed/25341679?tool=bestpractice.com
[12]Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019 Oct;92(4):321-25.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853045
http://www.ncbi.nlm.nih.gov/pubmed/31750430?tool=bestpractice.com
A successful hiatal hernia repair in conjunction with an antireflux procedure can provide a long-term cure for both hiatal hernia and gastroesophageal reflux disease, but this is a major procedure. The risks and benefits of surgery should be discussed carefully with each surgical candidate.
In the experience of specialty centers, surgical correction of a hiatal hernia will have a good to excellent long-term outcome in up to 90% of cases.[35]Furnée EJ, Draaisma WA, Simmermacher RK, et al. Long-term symptomatic outcome and radiologic assessment of laparoscopic hiatal hernia repair. Am J Surg. 2010 May;199(5):695-701.
http://www.ncbi.nlm.nih.gov/pubmed/19892314?tool=bestpractice.com
[36]Dallemagne B, Kohnen L, Perretta S, et al. Laparoscopic repair of paraesophageal hernia: long-term follow-up reveals good clinical outcome despite high radiological recurrence rate. Ann Surg. 2011 Feb;253(2):291-6.
http://www.ncbi.nlm.nih.gov/pubmed/21217518?tool=bestpractice.com
[37]Luketich JD, Nason KS, Christie NA, et al. Outcomes after a decade of laparoscopic giant paraesophageal hernia repair. J Thorac Cardiovasc Surg. 2010 Feb;139(2):395-404.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813424
http://www.ncbi.nlm.nih.gov/pubmed/20004917?tool=bestpractice.com
Even if recurrence does occur, it may not be symptomatic or require reoperation.