Evidence map›Paper›PMID 36278994›Full record

ArticleSurgical endoscopy2023

Percentage of intrathoracic stomach predicts operative and post-operative morbidity, persistent reflux and PPI requirement following laparoscopic hiatus hernia repair and fundoplication.

A M Cocco, V Chai, M Read, S Ward, M A Johnson, L Chong, C Gillespie, M W Hii

Open access · hybridFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.3field-weighted citation impact, top 11% 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, 14 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

A M CoccoThe Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Australia. anthonycocco02@gmail.com.ORCID http://orcid.org/0000-0002-3769-4582
V ChaiUpper GI and Hepatobiliary Surgical Unit, St Vincent's Hospital Melbourne, Melbourne, Australia.
M ReadThe Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Australia.
S WardUpper GI and Hepatobiliary Surgical Unit, St Vincent's Hospital Melbourne, Melbourne, Australia.
M A JohnsonThe Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Australia.
L ChongThe Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Australia.
C GillespieUpper GI and Hepatobiliary Surgical Unit, St Vincent's Hospital Melbourne, Melbourne, Australia.
M W HiiThe Department of Surgery, The University of Melbourne, St Vincent's Hospital Melbourne, Melbourne, Australia.
St Vincent's Hospital Melbourne · AUThe University of Melbourne · AUThe Royal Melbourne Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLarge hiatus hernias are relatively common and can be associated with adverse symptoms and serious complications. Operative repair is indicated in this patient group for symptom management and the prevention of morbidity. This study aimed to identify predictors of poor outcomes following laparoscopic hiatus hernia repair and fundoplication (LHHRaF) to aid in counselling potential surgical candidates. METHODOLOGY: A retrospective analysis was performed from a prospectively maintained, multicentre database of patients who underwent LHHRaF between 2014 and 2020. Revision procedures were excluded. Hernia size was defined as the intraoperative percentage of intrathoracic stomach, estimated by the surgeon to the nearest 10%. Predictors of outcomes were determined using a prespecified multivariate logistic regression model.

results625 patients underwent LHHRaF between 2014 and 2020 with 443 patients included. Median age was 65 years, 62.9% were female and 42.7% of patients had ≥ 50% intrathoracic stomach. In a multivariate regression model, intrathoracic stomach percentage was predictive of operative complications (P = 0.014, OR 1.05), post-operative complications (P = 0.026, OR 1.01) and higher comprehensive complication index score (P = 0.023, OR 1.04). At 12 months it was predictive of failure to improve symptomatic reflux (P = 0.008, OR 1.02) and persistent PPI requirement (P = 0.047, OR 1.02). Operative duration and blood loss were predicted by BMI (P = 0.004 and < 0.001), Type III/IV hernias (P = 0.045 and P = 0.005) and intrathoracic stomach percentage (P = 0.009 and P < 0.001). Post-operative length of stay was predicted by age (P < 0.001) and emergency presentation (P = 0.003).

conclusionIn a multivariate regression model, intrathoracic stomach percentage was predictive of operative and post-operative morbidity, PPI use, and failure to improve reflux symptoms at 12 months.

Indexed as

FundoplicationHernia, HiatalHerniorrhaphyAgedAged, 80 and overBlood Loss, SurgicalFemaleFollow-Up StudiesGastroesophageal RefluxHumansLaparoscopyMalePostoperative ComplicationsRetrospective StudiesFundoplicationHiatus hernia repairLaparoscopicMorbidityOesophagealReflux

Identifiers

PMID36278994
PMCPMC10017603
OpenAlexW4307179001

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read57
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.