ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018
Acute Vs. Elective Paraesophageal Hernia Repair: Endoscopic Gastric Decompression Allows Semi-Elective Surgery in a Majority of Acute Patients.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Acute paraesophageal hernia with gastric volvulus. Results of surgical treatment: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2025Pooled it
- Timing matters: a comparative analysis of semi-elective, elective, and emergent laparoscopic paraesophageal hernia repair.Surgical endoscopy · 2026Article
- Article
- Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients.Surgical endoscopy · 2026Observational
- Reflections on surgery for hiatal hernia.Updates in surgery · 2026Review
- Definitive, urgent repair of acutely incarcerated paraesophageal hernias is comparable to an elective repair.Surgical endoscopy · 2025Article
- Gastric Volvulus as a Complication of Giant Hiatal Hernia: A Case Report and Literature Review.Cureus · 2025Article
- Endoscopic Reduction of an Acute Gastric Volvulus.Cureus · 2024Article
- Large hiatus hernia: time for a paradigm shift?BMC surgery · 2022Article
- Impact of surgical repair on type IV paraesophageal hernias (PEHs).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
- Minimally invasive surgery for large hiatal hernia.Annals of gastroenterological surgery · 2019Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHistorically, patients presenting acutely with paraesophageal hernia and requiring urgent operation demonstrated inferior outcomes compared to patients undergoing elective repair.
methodsA prospective IRB-approved database was used to retrospectively review 570 consecutive patients undergoing paraesophageal hernia repair between 2000 and 2016.
resultsThirty-eight patients presented acutely (6.7%) and 532 electively. Acute presentation was associated with increased age (74 vs. 69 years) but similar age-adjusted Charlson comorbidity scores. A history of chest pain, intrathoracic stomach ≥75%, and mesoaxial rotation were more common in acute presentations. Emergency surgery was required in three patients (8%), and 35 patients were managed in a staged approach with guided decompression prior to semi-elective surgery. Acute presentation was associated with an increased hospital stay (5 (2-13) days vs. 4 (1-27) days, p = 0.001). There was no difference in postoperative Clavien-Dindo severity scores. One patient in the elective group died, and the overall mortality was 0.2%.
conclusionOur findings suggest that a majority of patients presenting with acute paraesophageal hernia can undergo a staged approach instead of urgent surgery with comparable outcomes to elective operations in high-volume centers. We suggest elective repair for patients presenting with a history of chest pain, intrathoracic stomach ≥75%, and a mesoaxial rotation.
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