Background/Objectives: Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are commonly used for allergic rhinitis (AR), yet limited research has directly compared their effects on quality of life (QoL). We aimed to assess QoL differences between SLIT and SCIT recipients. As both forms of immunotherapy have reported benefits, we hypothesize that patients undergoing SLIT and SCIT will have comparable QoL improvements. Methods: A cohort study included patients with AR treated with immunotherapy from 2018 to 2022. Patients with obstructive sleep apnea, primary ciliary dyskinesia, cystic fibrosis, vasculitis, rheumatoid arthritis, sarcoidosis, or lupus were excluded. QoL was evaluated using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at multiple time points. Demographics, additional therapies, and allergen sensitivities were recorded. Data were analyzed using SPSS Statistics. Results: A total of 41 participants were eligible for inclusion. Both SLIT and SCIT groups exhibited reductions from baseline RQLQ scores. Within SLIT recipients, 5/7 RQLQ domains significantly improved. SCIT recipients showed significant QoL enhancement in 3/7 domains. The mean difference between SLIT and SCIT cohorts was −0.18 (p = 0.57, d = −0.18, 95% CI [−0.79, 0.43] at a mean treatment time of 18 months. Conclusions: SLIT and SCIT showed comparable RQLQ score reductions after 18 months of therapy, suggesting similar QoL benefits between the two treatment paradigms. Further investigation is needed to explore SLIT vs. SCIT differences in long-term QoL improvements beyond two years.

Background: Despite surgical repair, large paraesophageal hernias (PEHs) often recur. To minimize recurrence, adjunctive measures, such as mesh and gastropexy, have been explored, but their impact on recurrence and reoperation rates remains unclear. Therefore, we analyzed our single-institution case series, where absorbable hiatal overlay mesh and percutaneous endoscopic gastrostomy (PEG) placement were utilized systematically. Methods: Patients undergoing laparoscopic large PEH repair by a single surgeon between 1 January 2006 and 31 May 2021 were identified. Demographic data, hernia size, number of hiatal sutures used, use of mesh and/or PEG, fundoplication type, and complications were extracted by retrospective chart review. Hernia recurrence was assessed though postoperative radiographic and endoscopic studies or need for reoperation. Fisher’s exact, chi-square, Mood’s two-median and t-tests were used for between-group comparisons. Generalized linear models were used to assess associations between mesh and PEG placement and number of hiatal sutures and to compare risk differences for recurrence between treatment types (partial versus complete fundoplication; mesh versus no mesh; and PEG versus no PEG). Kaplan–Meier estimator with log-rank test was used to assess time to recurrence. Results: Overall, 413 patients (median age 66 years) underwent laparoscopic large PEH repair and fundoplication (51% partial and 49% complete fundoplications). Of these, 78% had overlay absorbable mesh and 51% had a PEG. With an average follow-up time of over 5 years, we found 19.9% had radiographic or endoscopic recurrence. Although cohort stratification based on mesh implementation and fundoplication type did not identify differences in recurrence rates, significantly lower recurrence rates were noted in patients with PEG compared to no-PEG (14.8% vs. 23.5%, p = 0.01). Notably, of five reoperations, all were in complete fundoplication patients, and one occurred in a patient with PEG placement at the index operation. Conclusions: PEG placement during laparoscopic PEH repair may lead to fewer recurrences in high-risk patients. Future prospective studies are warranted.