Evidence map›Paper›PMID 38627258›Full record

ArticleSurgical endoscopy2024

Paraesophageal hernia recurrence following repair: making the case for reoperative surgery in a propensity-matched cohort.

Aditya Jog, Alexandra L Strauss Starling, Isha Kaur, Kenneth Um, Luke J Keele, Joseph R Triggs, Maria S Altieri, Jenny M Shao

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 39% 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, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. 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 3 institutions in 1 country.

Aditya JogUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Alexandra L Strauss StarlingDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Isha KaurUniversity of Pennsylvania, Philadelphia, PA, USA.
Kenneth UmUniversity of Pennsylvania, Philadelphia, PA, USA.
Luke J KeeleDepartment of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Joseph R TriggsDivision of Gastroenterology, Fox Chase Cancer Center, Philadelphia, PA, USA.
Maria S AltieriDepartment of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Jenny M ShaoDivision of Minimally Invasive Surgery, Department of Surgery, University of Michigan, 2926A Taubman Center, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA. jmshao@med.umich.edu.ORCID 0000-0002-9182-9548
University of Pennsylvania · USUniversity of Michigan · USFox Chase Cancer Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParaesophageal hernia repairs (PEHRs) have high rates of radiographic recurrence, with some patients requiring repeat operation. This study characterizes patients who underwent PEHR to identify the factors associated with postoperative symptom improvement and radiographic recurrence. We furthermore use propensity score matching to compare patients undergoing initial and reoperative PEHR to identify the factors predictive of recurrence or need for reoperation.

methodsAfter IRB approval, patients who underwent PEHR at a tertiary care center between January 2018 and December 2022 were identified. Patient characteristics, preoperative imaging, operative findings, and postoperative outcomes were recorded. A computational generalization of inverse propensity score weight was then used to construct populations of initial and redo PEHR patients with similar covariate distributions.

resultsA total of 244 patients underwent PEHR (78.7% female, mean age 65.4 ± 12.3 years). Most repairs were performed with crural closure (81.4%) and fundoplication (71.7%) with 14.2% utilizing mesh. Postoperatively, 76.5% of patients had subjective symptom improvement and of 157 patients with postoperative imaging, 52.9% had evidence of radiographic recurrence at a mean follow-up of 10.4 ± 13.6 months. Only 4.9% of patients required a redo operation. Hernia type, crural closure, fundoplication, and mesh usage were not predictors of radiographic recurrence or symptom improvement (P > 0.05). Propensity weight score analysis of 50 redo PEHRs compared to a matched cohort of 194 initial operations revealed lower rates of postoperative symptom improvement (P < 0.05) but no differences in need for revision, complication rates, ED visits, or readmissions.

conclusionsMost PEHR patients have symptomatic improvement with minimal complications and reoperations despite frequent radiographic recurrence. Hernia type, crural closure, fundoplication, and mesh usage were not significantly associated with recurrence or symptom improvement. Compared to initial PEHR, reoperative PEHRs had lower rates of symptom improvement but similar rates of recurrence, complications, and need for reoperation.

Indexed as

Hernia, HiatalHerniorrhaphyPropensity ScoreRecurrenceReoperationAgedFemaleFundoplicationHumansMaleMiddle AgedRetrospective StudiesSurgical MeshHernia recurrenceHiatal herniaParaesophageal herniaReoperative surgery

Identifiers

PMID38627258
OpenAlexW4394842109

What OpenQuestion holds

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Registered trials

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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.