Evidence map›Paper›PMID 32839876›Full record

ArticleSurgical endoscopy2021

Less is more: cruroplasty alone is sufficient for revisional hiatal hernia surgery.

Robert Nguyen, Colin P Dunn, Luke Putnam, Paul Won, Tanu Patel, Stephanie Brito, Nikolai A Bildzukewicz, John C Lipham

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Efficacy and safety of mesh reinforced cruroplasty with Phasix™ ST vs. Bio-AHernia : the journal of hernias and abdominal wall surgery · 2026
    Pooled it
  2. Article
  3. Cruroplasty as a standalone treatment for recurrent hiatal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024
    Article
  4. Article
  5. Article
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

8 authors at 1 institution in 1 country.

Robert Nguyen *The Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Colin P DunnThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Luke PutnamThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Paul WonThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Tanu PatelThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Stephanie BritoThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
Nikolai A BildzukewiczThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA.
John C LiphamThe Division of Upper GI and General Surgery, University of Southern California, Los Angeles, CA, USA. John.Lipham@med.usc.edu.
University of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecurrence of hiatal hernia after anti-reflux surgery is common, with past studies reporting recurrence rates of 10-15%. Most patients experience relief from GERD symptoms following initial repair; however, those suffering from recurrence can have symptoms severe enough to warrant another operation. Although the standard of care is to revise the fundoplication or convert to magnetic sphincter augmentation (MSA) in addition to redo cruroplasty, it stands to reason that with an intact fundoplication, a repeat cruroplasty is all that is necessary to alleviate the patients' symptoms. In other words, only fix that which is broken.

methodsA retrospective review of patients with symptomatic hiatal hernia recurrence who underwent reoperation between January 2011 and September 2018 was conducted. Patients who received revisional cruroplasty alone were compared with cruroplasty plus some other revision (fundoplication revision, or takedown and MSA placement). Demographics, operative details, and postoperative outcomes were collected.

resultsThere were 73 patients identified. Median time to recurrence after the first procedure was 3.7 (1.9-8.2) years. Thirty-two percent of the patients had GERD symptoms for more than 10 years. Twenty-six patients underwent cruroplasty only. Forty-seven patients underwent cruroplasty plus fundoplication revision. There were no significant differences in operative times (2.4 h cruroplasty alone, 2.8 h full revision, p = 0.75) or postoperative complications between the two groups. Patients had a mean follow-up time of 1.64 years. Of the 73 patients, 8 had subsequent hiatal hernia recurrence. The recurrence rate for patients with cruroplasty alone was 11%, and the recurrence rate for the full revision group was 12% (p = 1.00).

conclusionLeaving an intact fundoplication alone at the time of revisional surgery did not adversely affect surgical outcomes. This data suggests a role for hernia-only repair for recurrent hiatal hernias.

Indexed as

Gastroesophageal RefluxHernia, HiatalLaparoscopyFundoplicationHumansRecurrenceRetrospective StudiesTreatment OutcomeCruroplastyFundoplicationHiatal herniaRevision

Identifiers

PMID32839876
OpenAlexW3081173496

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.