Observational studySurgical endoscopy2026
Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients.
Observational study in Surgical endoscopy, 2026. 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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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.
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.
Who cites it
2 citing papers in PubMed.
- Acute gastric volvulus: optimal timing for repair?Surgical endoscopy · 2026Article
- Timing matters: a comparative analysis of semi-elective, elective, and emergent laparoscopic paraesophageal hernia repair.Surgical endoscopy · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of patients with acute paraesophageal hernia (APEH) remains to be standardized. This study evaluates the safety and outcomes of a novel staged approach for patients with APEH, which is based on gastric decompression followed by non-operative management and either emergency or semi-elective surgical treatment when deemed necessary. STUDY
designObservational study of a consecutive case series of APEH patients admitted to the hospital between 2007 and 2024, with a minimum follow-up of 3 months. All patients were managed according to the staged approach. Clinical outcomes including postoperative complications, recurrence, and readmission rates were assessed.
resultsFifty-eight patients (70.7% women) with a mean age of 81 ± 9.2 years (20.7% of patients aged over 90 years) and significant comorbidities were included. Early decompression via nasogastric tube and/or esophagogastroduodenoscopy relieved symptoms in 81% of cases, avoiding emergency surgery. Surgery was deemed unsuitable for 15 patients of whom 4 died due to acute complications, while 11 were successfully managed non-operatively. Surgical intervention was performed in 43 patients (74.1%) primarily through laparoscopic fundoplication, 10 of whom required urgent procedures. Compared to semi-elective repair, urgent surgery was associated with a higher rate of major postoperative complications (40% vs. 21.2%). Over a median follow-up of 27 months, 5 patients (11.6%) required readmission within a 90-day period and 3 (7%) experienced hernia recurrence. None of the patients died.
conclusionA staged approach for the management of APEH was feasible, with definitive repair achieved in 93% of surgical patients, via laparoscopy in 72% of cases, and without perioperative mortality.
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Registered trials
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