Evidence map›Paper›PMID 39134722›Full record

ArticleSurgical endoscopy2024

Optimizing outcomes in paraesophageal hernia repair: a novel critical view.

Zena Saleh, Vincent Verchio, Yazid K Ghanem, Johanna Lou, Erin Hundley, Armaun D Rouhi, Hansa Joshi, Mathew C Moccia, Dominick M Scalia, Austin M Lenart and 3 more

Abstract read
PubMed Full text at PMC Publisher
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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
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

13 authors.

Zena SalehDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Vincent VerchioDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Yazid K GhanemDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Johanna LouDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Erin HundleyRowan University, Woodbury, NJ, USA.
Armaun D RouhiDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Hansa JoshiDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Mathew C MocciaDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
Dominick M ScaliaCooper Medical School of Rowan University, Camden, NJ, USA.
Austin M LenartCooper Medical School of Rowan University, Camden, NJ, USA.
Zachary A LaddCooper Medical School of Rowan University, Camden, NJ, USA.
Kenji MinakataDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA.
David D ShersherDepartment of Surgery, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ, USA. shersher-david@cooperhealth.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe recurrence rate of paraesophageal hernia repair (PEHR) is high with reported rates of recurrence varying between 25 and 42%. We present a novel approach to PEHR that involves the visualization of a critical view to decrease recurrence rate. Our study aims to investigate the outcomes of PEHR following the implementation of a critical view.

methodsThis is a single-center retrospective study that examines operative outcomes in patients who underwent PEHR with a critical view in comparison to patients who underwent standard repair. The critical view is defined as full dissection of the posterior mediastinum with complete mobilization of the esophagus to the level of the inferior pulmonary vein, visualization of the left crus of the diaphragm as well as the left gastric artery while the distal esophagus is retracted to expose the spleen in the background. Bivariate chi-squared analysis and multivariable logistic and linear regressions were used for statistical analysis.

resultsA total of 297 patients underwent PEHR between 2015 and 2023, including 207 with critical view and 90 with standard repair which represents the historic control. Type III hernias were most common (48%) followed by type I (36%), type IV (13%), and type II (2.0%). Robotic-assisted repair was most common (65%), followed by laparoscopic (22%) and open repair (14%). Fundoplications performed included Dor (59%), Nissen (14%), Belsey (5%), and Toupet (2%). Patients who underwent PEHR with critical view had lower hernia recurrence rates compared to standard (9.7% vs 20%, P < .01) and lower reoperation rates (0.5% vs 10%, P < .001). There were no differences in postoperative complications on unadjusted bivariate analysis; however, adjusted outcomes revealed a lower odds of postoperative complications in patients with critical view (AOR .13, 95% CI .05-.31, P < .001).

conclusionWe present dissection of a novel critical view during repair of all types of paraesophageal hernia that results in reproducible, consistent, and durable postoperative outcomes, including a significant reduction in recurrence and reoperation.

Indexed as

Hernia, HiatalHerniorrhaphyRecurrenceAgedEsophagusFemaleHumansLaparoscopyMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRobotic Surgical ProceduresTreatment OutcomeCritical viewLaparoscopic surgeryParaesophageal hernia repairRecurrenceRobotic surgerySurgical mastery

Identifiers

PMID39134722
PMCPMC11362370

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.