ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2017
Non-Elective Paraesophageal Hernia Repair Portends Worse Outcomes in Comparable Patients: a Propensity-Adjusted Analysis.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Acute paraesophageal hernia with gastric volvulus. Results of surgical treatment: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2025Pooled it
- Age is Just a Number: Outcomes of Robotic Hiatal Hernia Repair in Octogenarians.Annals of thoracic surgery short reports · 2026Article
- Outcomes of emergent hiatal hernia repair: does specialty matter?Surgical endoscopy · 2026Article
- Emergent laparoscopic paraesophageal hernia repairs are associated with an increased risk of 30-day post-operative complications: a NSQIP analysis.Surgical endoscopy · 2025Article
- Restoration of normal anatomy without fundoplication in non-elective incarcerated giant paraesophageal hernia repair.Surgical endoscopy · 2025Article
- Interval operative management in patients admitted with acute obstruction due to incarcerated paraesophageal hernia.Surgical endoscopy · 2024Article
- BRAZILIAN HERNIA AND ABDOMINAL WALL SOCIETY STATEMENT ON LARGE HIATAL HERNIAS MANAGEMENT.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024Article
- Impact of surgical repair on type IV paraesophageal hernias (PEHs).Surgical endoscopy · 2022Article
- Elective paraesophageal hernia repair in elderly patients: an analysis of ACS-NSQIP database for contemporary morbidity and mortality.Surgical endoscopy · 2022Article
- Do Poor Functional Outcomes and Higher Morbidity Following Emergency Repair of Giant Hiatus Hernia Warrant Elective Surgery in Asymptomatic Patients?Frontiers in surgery · 2021Article
- Management of paraesophageal hernia review of clinical studies: timing to surgery, mesh use, fundoplication, gastropexy and other controversies.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2020Article
- Health-related quality of life after laparoscopic repair of giant paraesophageal hernia: how does recurrence in CT scan compare to clinical success?BMC surgery · 2020Observational
- Outcome of laparoscopic paraesophageal hernia repair in octogenarians: a registry-based, propensity score-matched comparison of 360 patients.Surgical endoscopy · 2019Article
- Acute Vs. Elective Paraesophageal Hernia Repair: Endoscopic Gastric Decompression Allows Semi-Elective Surgery in a Majority of Acute Patients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- Jejunal Diverticular Perforation Causing Small Bowel Obstruction in a Type 4 Hiatal Hernia: A Rare Case Report of a Nonagenarian Patient and Review of Relevant Literature.Case reports in surgery · 2017Article
- Emergent Repair of Paraesophageal Hernias and the Argument for Elective Repair.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionPatients undergoing non-elective paraesophageal hernia repair (PEHR) have worse perioperative outcomes. Because they are usually older and sicker, however, these patients may be more prone to adverse events, independent of surgical urgency. Our study aimed to determine whether non-elective PEHR is associated with differential postoperative outcome compared to elective repair, using propensity-score weighting.
methodsWe abstracted data for patients undergoing PEHR (n = 924; non-elective n = 171 (19 %); 1997-2010). Using boosted regression, we generated a propensity-weighted dataset. Odds of 30-day/in-hospital mortality and major complications after non-elective surgery were determined.
resultsPatients undergoing non-elective repair were significantly older, had more adverse prognostic factors, and significantly more major complications (38 versus 18 %; p < 0.001) and death (8 versus 1 %; p < 0.001). After propensity weighting, median absolute percentage bias across 28 propensity-score variables improved from 19 % (significant imbalance) to 5.6 % (well-balanced). After adjusting propensity-weighted data for age and comorbidity score, odds of major complications were still nearly two times greater (OR 1.67, CI 1.07-2.61) and mortality nearly three times greater (OR 2.74, CI 0.93-8.1) than for elective repair.
conclusionsEven after balancing significant differences in baseline characteristics, non-elective PEHR was associated with worse outcomes than elective repair. Symptomatic patients should be referred for elective repair by experienced surgeons.
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