Evidence map›Paper›PMID 40740916›Full record

ArticleWorld journal of gastrointestinal surgery2025

Removal of the sac during surgery for the repair of "giant" paraesophageal hernias.

Vahe M Hakobyan, Areg A Petrosyan, Hayk H Yeghiazaryan, Andranik Y Aleksanyan, Hayk H Safaryan, Hakob H Shmavonyan, Karen T Papazyan, Khachik H Ayvazyan, Levon G Davtyan, Aram A Khachatryan and 2 more

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Article in World journal of gastrointestinal surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Vahe M HakobyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Areg A PetrosyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Hayk H YeghiazaryanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Andranik Y AleksanyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Hayk H SafaryanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Hakob H ShmavonyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Karen T PapazyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Khachik H AyvazyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Levon G DavtyanDepartment of Radiology, Mikaelyan Institute of Surgery, Yerevan 0052, Armenia.
Aram A KhachatryanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.
Ghukas S SargsyanClinic of Surgery, Mikaelyan Institute of Surgery, Yerevan 0052, Armenia.
Suren A StepanyanDepartment of Surgery 1, Yerevan State Medical University, Yerevan 0025, Armenia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe presence of a large paraesophageal hernia is a source of concern in foregut surgery. Thus, scholars have focused on ascertaining the optimal surgical approach, methods for reinforcing the esophageal hiatus, and strategies for preventing hernia recurrence and gastroesophageal reflux.

aimTo investigate the outcomes of surgery for giant paraesophageal hernias without sac removal.

methodsSixty-six consecutive patients who underwent surgery for a giant paraesophageal hernia between May 2010 and December 2024 were included in this retrospective study. The pre- and postoperative examinations included upper gastrointestinal endoscopy, X-ray with barium contrast swallow, contrast-enhanced computed tomography (CT) scans of the chest and abdomen, 24-hour potential hydrogen esophageal monitoring, and esophagomanometry. The study group included 36 patients who underwent surgery without sac removal, and the control group included 30 patients who underwent surgery with sac removal.

resultsFifty-two patients (28 in the study group and 24 in the control group) underwent laparoscopic procedures, 10 (6 in the study group and 4 in the control group) underwent open procedures, and 4 (2 in each group) underwent conversion procedures. The operative time and postoperative length of stay were significantly longer in the control group than in the study group. In 12 patients in the study group, X-ray examination on postoperative days 3-5 revealed air-fluid levels at the site of the remaining hernia sac; all air-fluid levels disappeared without intervention 2 months later. Postoperative day 60 CT and X-ray examinations revealed no pathological changes related to the hernia sac in the mediastinum.

conclusionRemoval of the hernia sac during surgery for giant paraesophageal hernias is not mandatory. Further large-scale multicentric randomized trials are needed for a more detailed investigation in this field.

Indexed as

Hernia repairHernia sacHiatal herniaLaparoscopic fundoplicationParaesophageal hernia

Identifiers

PMID40740916
PMCPMC12305281

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