Evidence map›Paper›PMID 30661178›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2019

Laparoscopic repair of type III/IV giant para-oesophageal herniae with biological prosthesis: a single centre experience.

A K Shrestha, M Joshi, L DeBono, K Naeem, S Basu

Abstract read
PubMed Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. One-year outcomes of biological mesh in hiatal hernia repair: a real-world study.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Article
  4. Article
  5. Article
  6. 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 2 institutions in 1 country.

A K ShresthaDepartment of General Surgery, East Kent Hospitals University NHS Foundation Trust (EKHUFT), Ashford, Kent, UK.
M JoshiDepartment of General Surgery, East Kent Hospitals University NHS Foundation Trust (EKHUFT), Ashford, Kent, UK.
L DeBonoDepartment of Surgery, One Ashford Hospital, Willesborough, Ashford, Kent, UK.
K NaeemDepartment of Radiology, EKHUFT, Ashford, Kent, UK.
S BasuDepartment of Surgery, EKHUFT, Ashford, Kent, UK. sanjoy.basu@nhs.net.
Ashford Hospital · GBEast Kent Hospitals University NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRepair of giant paraoesophageal herniae (GPEH) is technically challenging and requires significant experience in advanced foregut surgery. Controversy continues on suture versus mesh cruroplasty with the most recent systematic review and meta-analysis putting the onus on the operating surgeon. Study aim was to review whether the biological prosthesis (non-cross-linked bovine pericardium and porcine dermis) and the technique adopted for patients with GPEH had an influence on clinical and radiological recurrences.

methodA retrospective analysis of a prospectively collected data of 60 consecutive patients with confirmed 5 cm hiatus hernia and ≥ 30% stomach displacement in the thorax that were operated in the upper gastrointestinal unit of a large district general hospital between September 2010 and August 2017. Pre and post-surgery Gastro-Oesophageal Reflux Disease Questionnaire [(GORD-HRQOL)] and a follow up contrast study were completed.

results60 included 2 (3%) and 58 (97%) emergency and elective procedures respectively with a male: female ratio of 1:3, age 71* (Median) (42-89) years, BMI 29* (19-42) and 26 (43%) with ASA III/IV. Investigations confirmed 46* (37-88) mm and 42* (34-77) mm transverse and antero-posterior hiatal defect respectively with 60* (30-100)% displacement of stomach into chest. Operative time and length of stay was 180* (120-510) minutes and 2* (1-30) days respectively. One (2%) converted for bleeding and 2 (3%) peri-operative deaths. Five (8%), 5 (8%) and 4 (7%) have dysphagia, symptomatic and radiological recurrences respectively. GORD-HRQOL recorded preoperatively was 27* (10-39) dropping significantly postoperatively to 0* (0-21) (P < 0.005) with 95% patient satisfaction at a follow up of 60* (36-84) months.

conclusionsOur technique of laparoscopic GPEH repair with biological prosthesis is safe with a reduced symptomatic and radiological recurrence and an acceptable morbidity and mortality.

Indexed as

AdultAgedAged, 80 and overAnimalsBioprosthesisCattleFemaleFollow-Up StudiesGastroesophageal RefluxHernia, HiatalHerniorrhaphyHumansLaparoscopyMaleMiddle AgedOperative TimeAnti-reflux procedureBiological prosthesisCruroplastyGiant paraoesophageal herniaeGORD-HRQOL score

Identifiers

PMID30661178
OpenAlexW2909477500

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.