ArticleSurgical endoscopy2025
Emergent laparoscopic paraesophageal hernia repairs are associated with an increased risk of 30-day post-operative complications: a NSQIP analysis.
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 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Too old to operate? Retrospective outcomes of laparoscopic paraesophageal hernia repair in nonagenarians.Surgical endoscopy · 2026Article
- Timing matters: a comparative analysis of semi-elective, elective, and emergent laparoscopic paraesophageal hernia repair.Surgical endoscopy · 2026Article
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Authors and funding
9 authors.
Funding
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Abstract
backgroundParaesophageal hernias exhibit diverse anatomical variations, and while elective repair is standard for symptomatic cases, larger Types II-IV hernias can necessitate emergent intervention. Despite a recognized demographic trend in emergent cases, a consensus on post-operative outcomes is lacking. This study aims to assess the 30-day post-operative outcomes of elective and emergent laparoscopic paraesophageal hernia (PEH) repair.
methodsThis analysis queried the ACS-NSQIP database from 2011 to 2020, focusing on elective and emergent laparoscopic PEH repairs. Procedures resulting in any resection or conversion to open were excluded. A propensity score matching analysis with a 1:4 ratio was conducted to assess 30-day post-operative outcomes between elective and emergent laparoscopic paraesophageal hernia repair. Additional sensitivity analyses across multiple matching ratios (1:1 to 1:6) and multivariable logistic regression were performed to evaluate the robustness of the initial findings.
resultsEight hundred and four patients underwent emergent laparoscopic PEH repair and 36,926 patients underwent elective repair. Patients who underwent emergent repair were significantly older (p < 0.0001) with lower BMI (p < 0.0001). On propensity score-matched analysis, emergent cases were associated with a significantly higher risk of sepsis (p < 0.0001), infection (p = .0030), transfusion (p < 0.0001), reoperation (p = .0020), longer length of stay (p < 0.0001), pulmonary complications (p < 0.0001), and renal complications (p = .0002).
conclusionDespite the existing literature's discordant findings, our study showed that emergent laparoscopic PEH repairs are associated with significantly worse 30-day outcomes compared to elective laparoscopic PEH repairs. The higher rates of post-operative complications in emergent cases emphasize the need for careful patient selection and procedural planning. Temporizing measures with planned staged repair can be considered a potential strategy in emergent cases.
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