ArticleBMC surgery2022
Large hiatus hernia: time for a paradigm shift?
Article in BMC surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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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.
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.
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Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Association between mesh reinforcement and postoperative gastroparesis following paraesophageal and hiatal hernia repair: a propensity-matched analysis.Surgical endoscopy · 2026Article
- Postoperative quality of life after minimally invasive repair of giant hiatal hernias.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Effect of intraoperative crural block on first-day postoperative pain after laparoscopic hiatal hernia repair: a two-center retrospective study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Long-term surgical outcomes for the surgical management of complete intrathoracic stomach (CIS).Surgical endoscopy · 2026Article
- Re: Comments on Article "Fixation of the Esophagus to Diaphragmatic Hiatus as a Routine Step in Hiatal Hernia Repair During Bariatric Surgery: How to Do It?"Obesity surgery · 2025Article
- A standardized robot-assisted technique for giant paraesophageal hernia repair: the relationship between surgical details and low recurrence rate in long-term follow-up.Langenbeck's archives of surgery · 2025Observational
- Article
- Outcomes of elective repair of large hiatus hernias in the morbidly obese: a cohort study.Surgical endoscopy · 2025Article
- A safety and effectiveness evaluation of refluxstop in the treatment of acid reflux comparing large and small hiatal hernia groups: results from 99 patients in Switzerland with up to 4-years follow-up.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Safety and Early Clinical Outcomes Following Repair of Very Large Hiatus Hernia in Octogenarians.World journal of surgery · 2025Article
- Giant Paraesophageal Hernia Presenting With Dyspnea: A Case Report With Surgical Considerations.Cureus · 2025Article
- Spontaneous Mediastinal Gastric Perforation in Hiatal Hernia with Difficult Surgical Technique Selection: A Case Report.Yonago acta medica · 2024Article
- Functional results after hiatal repair and gastropexy without fundoplication in patients with paraoesophageal hernia.Langenbeck's archives of surgery · 2024Article
- Adjuvant Botulinum Toxin Type A on the Management of Giant Hiatal Hernia: A Case Report.Cureus · 2024Article
- Emergency surgery for hiatus hernias: does technique affect outcomes? A single-centre experience.Updates in surgery · 2023Observational
- Hiatus hernia repair with a new-generation biosynthetic mesh: a 4-year single-center experience.Surgical endoscopy · 2023Article
- Percentage of intrathoracic stomach predicts operative and post-operative morbidity, persistent reflux and PPI requirement following laparoscopic hiatus hernia repair and fundoplication.Surgical endoscopy · 2023Article
- Comment on "Sutured Versus Mesh-Augmented Hiatus Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" by Petric J, Bright T, Liu DS, et al.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic large hiatal hernia (LHH) repair remains a challenge despite three decades of ongoing attempts at improving surgical outcome. Its rarity and complexity, coupled with suboptimal initial approach that is usually best suited for small symptomatic herniae have contributed to unacceptable higher failure rates.
resultsWe have therefore undertaken a systematic appraisal of LHH with a view to clear out our misunderstandings of this entity and to address dogmatic practices that may have contributed to poor outcomes.
conclusionsFirst, we propose strict criteria to define nomenclature in LHH and discuss ways of subcategorising them. Next, we discuss preoperative workup strategies, paying particular attention to any relevant often atypical symptoms, indications for surgery, timing of surgery, role of surgery in the elderly and emphasizing the key role of a preoperative CT imaging in evaluating the mediastinum. Some key dissection methods are then discussed with respect to approach to the mediastinal sac, techniques to avoid/deal with pleural breach and rationale to avoid Collis gastroplasty. The issues pertaining to the repair phase are also discussed by evaluating the merits of the cruroplasty, fundoplication types and gastropexy. We end up debating the role of mesh reinforcement and assess the evidence with regards to recurrence, reoperation rate, complications, esophageal dilatation, delayed gastric emptying and mortality. Lastly, we propose a rationale for routine postoperative investigations.
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Registered trials
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.