ArticleUnited European gastroenterology journal2020
The natural course of giant paraesophageal hernia and long-term outcomes following conservative management.
Article in United European gastroenterology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Preoperative CT-based quantitative assessment of hernial SAC predicts early recurrence following primary hiatal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Article
- Breaking Boundaries: A Case Report of Giant Hiatal Hernia Housing Pancreas, Stomach, Small Bowel, and Colon.Cureus · 2025Article
- Understanding fundamental differences in symptomatic outcomes of hiatal versus paraoesophageal hernia robotic repairs.Journal of robotic surgery · 2024Article
- Article
- Small Bowel Obstruction Caused by Type IV Hiatal Hernia.Case reports in surgery · 2024Article
- Surgical Repair of Large Hiatal Hernias: Insight from a High-Volume Center.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Dyspnoea improves following composite repair of giant paraoesophageal hernia.Annals of the Royal College of Surgeons of England · 2023Article
- An unusual case of a tension pneumothorax.Journal of surgical case reports · 2022Article
- Impact of surgical repair on type IV paraesophageal hernias (PEHs).Surgical endoscopy · 2022Article
- Minimally Invasive Abdominal Repair of a Giant Paraesophageal Hiatal Hernia with Occupation of the Right Thorax in a 53-Year-Old Man.Case reports in surgery · 2022Article
- UEGWeek: The modern School of Athens.United European gastroenterology journal · 2021Article
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Authors and funding
7 authors.
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Abstract
backgroundAccurate information on the natural course of giant paraesophageal hernia is scarce, challenging therapeutic decisions whether or not to operate.
objectiveWe aimed to investigate the long-term outcomes, including hernia-related deaths and complications (e.g. volvulus, gastrointestinal bleeding, strangulation) of patients with giant paraesophageal hernia that were conservatively managed, and to determine factors associated with clinical outcome.
methodsWe retrospectively analysed charts of patients diagnosed with giant paraesophageal hernia between January 1990 and August 2019, collected from a university hospital in The Netherlands. Included patients were subdivided into three groups based on primary therapeutic decision at diagnosis. Radiological, clinical and surgical characteristics, along with long-term outcomes at most recent follow-up, were collected.
resultsWe included 293 patients (91 men, mean age 70.3 ± 12.4 years) with a mean duration of follow-up of 64.0 ± 58.8 months. Of the 186 patients that were conservatively treated, a total hernia-related mortality of 1.6% was observed. Hernia-related complications, varying from uncomplicated volvulus to strangulation, occurred in 8.1% of patients. Only 1.1% of patients included in this study required emergency surgery. Logistic regression analysis revealed the presence of symptoms (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.8-20.6), in particular obstructive symptoms (vomiting, OR 15.7, 95% CI 4.6-53.6; epigastric pain, OR 4.4, 95% CI 1.2-15.8 and chest pain, OR 6.1, 95% CI 1.8-20.6) to be associated with the occurrence of hernia-related complications.
conclusionsHernia-related death and morbidity is low in conservatively managed patients. The presence of obstructive symptoms was found to be associated with the occurrence of complications during follow-up. Conservative therapy is an appropriate therapeutic strategy for asymptomatic patients.
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