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ArticleHernia : the journal of hernias and abdominal wall surgery2025

Frailty predicts recurrence after laparoscopic Nissen fundoplication with mesh cruroplasty for giant sliding hiatal hernia with severe reflux esophagitis in elderly patients: a multicenter retrospective study.

Tamer A A M Habeeb, Abdulzahra Hussain, Alberto Aiolfi, Jose Bueno- Lledó, Massimo Chiaretti, Igor A Kryvoruchko, Mohammad Kermansaravi, Abdelrahman Nimeri, Abd Al-Kareem Elias, Saad Mohamed Ali Ahmed and 29 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
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

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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. Evaluation of the safety and effectiveness of crural reinforcement with bio-aHernia : the journal of hernias and abdominal wall surgery · 2025
    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

39 authors.

Tamer A A M HabeebDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt. tameralnaimy@hotmail.com.ORCID 0000-0002-7049-4267
Abdulzahra HussainGeneral Surgery Department, Homerton University Hospital, London, UK.
Alberto AiolfiDivision of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Milan, Milan, Italy.
Jose Bueno- LledóHospital Universitari i Politècnic la Fe, Valencia, Spain.
Massimo ChiarettiDepartment of General Surgery Specialties and Organ Transplant, Faculty of Pharmacy and Medicine, Sapienza Rome University, Rome, Italy.
Igor A KryvoruchkoDepartment of Surgery, No.2, Kharkiv National Medical University, kharkivs'Ka oblast, Ukraine.
Mohammad KermansaraviDepartment of Surgery, Division of Minimally Invasive and Bariatric Surgery, Minimally Invasive Surgery Research Center, Hazrat-E Fateme Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abdelrahman NimeriDepartment of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Abd Al-Kareem EliasDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Saad Mohamed Ali AhmedDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Esmail Tharwat Kamel AwadDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Mohamed A GadallahDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Ahmed KhyrallhDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Mohammed H AlsayedDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assuit Branch, Assuit, Egypt.
Mohamed Fathy LabibGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Sobhy Rezk Ahmed TeamaGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Abdelhafez SeleemGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammed Hassan ElshafeyGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mostafa Mahmoud Salama MostafaGeneral Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hamdi ElbelkasiMataryia Teaching Hospital (GOTHI), Cairo, Egypt.
Mahmoud Ali Abou ZaidGeneral Surgery Department, El Mahala Hepatic Institute, Al Gharbia, Egypt.
Ahmed HamdyDepartment of Hepato-Bilio-Pancreatic (HBP) Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Mohamed Ibrahim Abo AlsaadGeneral Surgery Department-Faculty of Medicine, Merit University, Sohag, Egypt.
Maged Z YoussefLecturer of General Surgery, Faculty of Medicine, October 6th University, Giza Governorate, Egypt.
Rasha Mohamed Motawea AliDepartment of General Surgery, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Ibtsam AbdelMaksoud Mohamed El ShamyDepartment of General Surgery, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt.
Ahmed Salah ArafaDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Ibrahim A HeggyDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Sameh Mohamed NaguibDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Tamer WasefyDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Mohamed AbozaidDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Tamer Mohamed ElshahidyDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Abdelshafy MostafaDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Mohamed ElnemrDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Abdelrahman Mohamed Hasanin NawarDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Mostafa M KhairyDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Ahmed Mesbah AbdelazizDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Abdelfatah H AbdelwanisDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.
Ahmed M El TelitiDepartment of General Surgery, Faculty of Medicine, Zagazig University, 1 Faculty of Medicine Street, Zagazig, Sharkia, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGiant sliding hiatal hernias (HH) are prevalent in the elderly population (EP) and often present with multiple comorbidities and a high surgical risk. Frailty has been increasingly recognized as a predictor of surgical outcomes in the EP. This study assessed the rate of recurrent sliding HH following mesh cruroplasty and laparoscopic Nissen fundoplication (LNF), and evaluated frailty as a potential risk factor of recurrence.

methodsThis retrospective multicenter study included 266 patients aged ≥ 60 years who underwent mesh cruroplasty and LNF for giant sliding HH (> 5 cm) with severe reflux esophagitis (Demeester score > 100) between March 2016 and March 2022, stratified into non-recurrence (n = 241) and recurrence (n = 25) HH.

resultsThe mean age was 66.92 ± 4.3 years vs. 67.79 ± 3.7 years in the non-recurrence and recurrence group, respectively. Twenty-five (9.4%) patients developed recurrent HH, with a median size of 5.2 cm (4.1-6.0 cm), and the median time from surgery to recurrence was 16 months (13-20 months). Frailty was significantly correlated with recurrence, with moderately and severely frail patients demonstrating higher recurrence rates (44% vs. 17%, p = 0.02). Multivariate analysis confirmed that frailty was an independent predictor of recurrence (odds ratio [OR], 1.4; 95% CI, 1.003-1.982; p = 0.04). Time to recurrence included mild frailty (75% recurrence rate within 16 months), moderate frailty (90.9% recurrence within 12 months), and severe frailty (80% recurrence within 9 months).

conclusionsFrailty was an independent predictor of HH recurrence. Integrating frailty assessment into preoperative workflows could optimize patient selection and outcomes.

Indexed as

Esophagitis, PepticFrailtyFundoplicationHernia, HiatalHerniorrhaphyLaparoscopySurgical MeshAgedFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesRisk FactorsSeverity of Illness IndexElderlyFrailtyGastroesophageal reflux diseaseGiant HHMesh cruroplastyNissen fundoplication

Identifiers

PMID40679643
PMCPMC12274264

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