Evidence map›Paper›PMID 30350095›Full record

ArticleSurgical endoscopy2019

Morbidity and mortality in complex robot-assisted hiatal hernia surgery: 7-year experience in a high-volume center.

Alexander C Mertens, Rob C Tolboom, Hana Zavrtanik, Werner A Draaisma, Ivo A M J Broeders

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PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. International Society for Diseases of the Esophagus consensus on management of the failed fundoplication.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2024
    Guideline
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  18. Surgical Anatomy of Paraesophageal Hernias.Thoracic surgery clinics · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Alexander C MertensDepartment of Surgery, Meander Medical Center, P.O. box 1502, 3800 BM, Amersfoort, The Netherlands.
Rob C TolboomDepartment of Surgery, Meander Medical Center, P.O. box 1502, 3800 BM, Amersfoort, The Netherlands.
Hana ZavrtanikDepartment of Surgery, Meander Medical Center, P.O. box 1502, 3800 BM, Amersfoort, The Netherlands.
Werner A DraaismaDepartment of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
Ivo A M J BroedersDepartment of Surgery, Meander Medical Center, P.O. box 1502, 3800 BM, Amersfoort, The Netherlands. iamj.broeders@meandermc.nl.
Meander Medisch Centrum · NLJeroen Bosch Ziekenhuis · NLUniversity of Ljubljana · SIUniversity of Twente · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPublished data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center. MATERIALS AND

methodsAll patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated. Primary endpoints were 30-day morbidity and mortality. Major complications were defined as Clavien-Dindo ≥ IIIb.

resultsPrimary surgery 211 primary surgeries were performed by two surgeons. The median age was 67 (IQR 58-73) years. 84.4% of patients had a type III or IV hernia (10.9% Type I; 1.4% Type II; 45.5% Type III; 38.9% Type IV, 1.4% no herniation). In 3.3% of procedures, conversion was required. 17.1% of patients experienced complications. The incidence of major complications was 5.2%. Ten patients (4.7%) were readmitted within 30 days. Symptomatic early recurrence occurred in two patients (0.9%). The 30-day mortality was 0.9%. Redo surgery 151 redo procedures were performed by two surgeons. The median age was 60 (IQR 51-68) years. In 2.0%, the procedure was converted. The overall incidence of complications was 10.6%, while the incidence of major complications was 2.6%. Three patients (2.0%) were readmitted within 30 days. One patient (0.7%) experienced symptomatic early recurrence. No patients died in the 30-day postoperative period.

conclusionsThis study provides valuable information on robot-assisted laparoscopic repair of primary or recurrent hiatal hernia and anti-reflux surgery for both patient and surgeon. Serious morbidity of 5.2% in primary surgery and 2.6% in redo surgery, in this large series with a high surgeon caseload, has to be outweighed by the gain in quality of life or relief of serious medical implications of hiatal hernia when counseling for surgical intervention.

Indexed as

Gastroesophageal RefluxHerniorrhaphyLaparoscopyPostoperative ComplicationsQuality of LifeRobotic Surgical ProceduresFemaleFundoplicationHernia, HiatalHumansMaleMiddle AgedNetherlandsOutcome and Process Assessment, Health CareRecurrenceReoperationAnti-refluxHiatal herniaRedoRefluxRoboticsSurgery

Identifiers

PMID30350095
OpenAlexW2896161537

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.