Evidence map›Paper›PMID 34076763›Full record

ArticleSurgical endoscopy2022

Characteristics and outcomes of patients undergoing paraesophageal hernia repair with selective use of biologic mesh.

Colette S Inaba, Brant K Oelschlager, Robert B Yates, Saurabh Khandelwal, Judy Y Chen, Andrew S Wright

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. 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
  6. 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

6 authors.

Colette S InabaDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA.
Brant K OelschlagerDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA.
Robert B YatesDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA.
Saurabh KhandelwalDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA.
Judy Y ChenDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA.
Andrew S WrightDepartment of Surgery, University of Washington, 1959 NE Pacific Street, PO Box 356410, Seattle, WA, 98195, USA. awright2@uw.edu.ORCID 0000-0002-9004-0561

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of biologic mesh in paraesophageal hernia repair (PEHR) has been associated with decreased short-term recurrence but no statistically significant difference in long-term recurrence. Because of this, we transitioned from routine to selective use of mesh for PEHR. The aim of this study was to examine our indications for selective mesh use and to evaluate patient outcomes in this population.

methodsWe queried a prospectively maintained database for patients who underwent laparoscopic PEHR with biologic mesh from October 2015 to October 2018, then performed a retrospective chart review. The decision to use mesh was made intraoperatively by the surgeon. Recurrence was defined as the presence of > 2 cm intrathoracic stomach on postoperative upper gastrointestinal (UGI) series.

resultsMesh was used in 61/169 (36%) of first-time PEHRs, and in 47/82 (57%) of redo PEHRs. Among first-time PEHRs, the indications for mesh included hiatal tension (85%), poor crural tissue quality (11%), or both (5%). Radiographic recurrence occurred in 15% of first-time patients (symptomatic N = 2, asymptomatic N = 3). There were no reoperations for recurrence. Among redo PEHRs, the indication for mesh was most commonly the redo nature of the repair itself (55%), but also hiatal tension (51%), poor crural tissue quality (13%), or both (4%). Radiographic recurrence occurred in 21% of patients (symptomatic N = 4, asymptomatic N = 1). There was 1 reoperation for recurrence in the redo-repair group.

conclusionsWe selectively use biologic mesh in a third of our first-time repair patients and in over half of our redo-repair patients when there is a perceived high risk of recurrence based on hiatal tension, poor tissue quality, or prior recurrence. Despite the high risk for radiologic recurrence, there was only 1 reoperation for recurrence in the entire cohort.

Indexed as

Biological ProductsHernia, HiatalLaparoscopyHerniorrhaphyHumansRecurrenceRetrospective StudiesSurgical MeshTreatment OutcomeBiological ProductsHiatal herniaMeshParaesophageal herniaRecurrenceReoperation

Identifiers

PMID34076763

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.