Evidence map›Paper›PMID 40490580›Full record

ArticleSurgical endoscopy2025

Paraesophageal hernia repair with concurrent bariatric surgery: a single institution experience on safety, benefit, and outcomes in obese patients.

Emily F Simon, Christina S Boutros, Erik L Risa, Jamie R Benson, Patrick Wieland, Saher-Zahra Khan, Hamza N Chatha, Juan Antonio Paredes Vasquez, Christine E Alvarado, Samuel J Zolin and 4 more

Abstract read
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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

14 authors.

Emily F SimonDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. Emily.simon2@uhhospitals.org.ORCID http://orcid.org/0000-0003-0873-8336
Christina S BoutrosDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Erik L RisaDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Jamie R BensonDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Patrick WielandDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Saher-Zahra KhanDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Hamza N ChathaDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Juan Antonio Paredes VasquezDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Christine E AlvaradoDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Samuel J ZolinDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Leena KhaitanDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Mujjahid AbbasDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Joshua LyonsDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Jeffrey M MarksDepartment of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is a significant risk factor for paraesophageal hernias (PEHs). While concurrent PEH repair and bariatric surgery have been shown to be safe when bariatric surgery is the primary indication, limited data exist on outcomes when PEH repair is the primary indication. This study evaluates the safety and benefits of concurrent bariatric surgery in obese patients undergoing PEH repair.

methodsA retrospective cohort study was conducted using data from a single academic institution between 2010 and 2023. Patients who underwent PEH repair alone or with concurrent bariatric surgery - Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) - and had a body mass index (BMI) of 30 or more were included. Outcomes analyzed included hernia recurrence, 30-day complications, postoperative gastroesophageal reflux disease (GERD), dysphagia, and reoperation rates. Multivariable logistic regression models were used to assess risk factors for recurrence and complications.

resultsA total of 526 patients with obesity met inclusion criteria: 296 (56.3%) underwent PEH repair alone, 128 (24.3%) underwent PEH repair with RYGB, and 102 (19.4%) underwent PEH repair with SG. Patients undergoing concurrent bariatric surgery had significantly lower hernia recurrence rates (PEH alone: 17.6% vs RYGB: 8.6% and SG: 7.8%; p < 0.01). Dysphagia was also less common in the bariatric cohorts (p < 0.01). However, RYGB patients had a higher 30-day complication rate (13.3%) compared to PEH alone (4.1%) and SG (2.0%) (p < 0.001). Obesity severity did not independently predict recurrence or complications.

conclusionConcurrent bariatric surgery at the time of PEH repair is associated with reduced hernia recurrence and dysphagia without increasing overall major complications. These findings support a combined surgical approach in obese patients requiring PEH repair. Future prospective studies should further refine patient selection criteria.

Indexed as

Bariatric SurgeryHernia, HiatalHerniorrhaphyObesityObesity, MorbidAdultFemaleGastrectomyGastric BypassHumansMaleMiddle AgedPostoperative ComplicationsRecurrenceReoperationRetrospective StudiesBariatric surgeryForegut surgeryMinimally invasive surgeryObesityParaesophageal hernia recurrenceParaesophageal hernia repair

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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.