Evidence map›Paper›PMID 34796379›Full record

ArticleSurgical endoscopy2022

Impact of surgical repair on type IV paraesophageal hernias (PEHs).

María Rita Rodríguez-Luna, Margherita Pizzicannella, Claudio Fiorillo, Abdullah Almuttawa, Alfonso Lapergola, Didier Mutter, Jacques Marrescaux, Bernard Dallemagne, Silvana Perretta

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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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 26% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Transverse colon incarceration and necrosis in a hiatal hernia: a case report.International journal of surgery case reports · 2026
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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

9 authors at 5 institutions in 3 countries.

María Rita Rodríguez-LunaResearch Institute against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg, France. rita.rodriguez-luna@ircad.fr.ORCID http://orcid.org/0000-0002-6560-0176
Margherita PizzicannellaICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France.
Claudio FiorilloFondazione Policlinico Universitario A. Gemelli IRCCS, 8 Largo A. Gemelli, 0016, Rome, Italy.
Abdullah AlmuttawaDepartment of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.
Alfonso LapergolaDepartment of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.
Didier MutterDepartment of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.
Jacques MarrescauxResearch Institute against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg, France.
Bernard DallemagneResearch Institute against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg, France.
Silvana PerrettaResearch Institute against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg, France.
Institut de Recherche contre les Cancers de l’Appareil Digestif · FRHôpital Civil, Strasbourg · FRLaboratoire des Sciences de l'Ingénieur, de l'Informatique et de l'Imagerie · FRAgostino Gemelli University Polyclinic · ITUniversity of Jeddah · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParaesophageal hernias (PEHs; types II-III-IV) account for about 5% of all hiatal hernias (HHs). The peculiarity of PEHs is the presence of a herniated sac which contains a more or less important part of the stomach, along with other abdominal organs in type IV PEHs. Surgical treatment is more complex since it requires a reduction not only of the herniated content but also of the "container," namely the sac adherent to mediastinal structures. Since type III and IV PEHs are mostly grouped together as large PEHs, there is a lack of articles in the literature with regards to clear surgical outcomes, as well as management algorithms in type IV PEHs. This study aims to compare outcomes in type IV vs. type III PEHs after surgical repair.

methodsA retrospective study of patients who underwent laparoscopic PEH hernia repair (LPEHR) was conducted in a single institution between 2006 and 2020. Patient baseline characteristics and surgical outcomes were analyzed.

resultsA total of 103 patients were included in the analysis. Patients presenting with type IV PEHs (12/103) were significantly older than patients with type III PEHs (91/104) (75.25 ± 7.15 vs. 66.91 ± 13.58 respectively (p = 0.039), and more fragile with a higher Charlson Comorbidity Index (CCI) (4.25 ± 1.48 vs. 2.96 ± 1.72, p = 0.016). Operative time was significantly longer (243 ± 101.73 vs. 133.38 ± 61.76, p = 0.002), and postoperative morbidity was significantly higher in type IV PEH repair (50% vs. 8.8% type III, p = 0.000).

conclusionPatients with type IV PEHs appear to be older and frailer. The higher incidence of postoperative complications in patients with type IV PEHs should advocate for a precise indication for surgical treatment, which should be performed in centers of expertise.

Indexed as

Hernia, HiatalLaparoscopyFundoplicationHerniorrhaphyHumansPostoperative ComplicationsRetrospective StudiesTreatment OutcomeComplicationsGastric volvulusNissen fundoplicationOutcomesParaesophageal herniaType IV

Identifiers

PMID34796379
OpenAlexW3214054538

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.