Observational studyDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2026
Gastropexy may reduce symptomatic recurrence in paraesophageal hernia repair: a Scandinavian retrospective multicenter study.
Observational study in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2026. 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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Abstract
Paraesophageal hernia (PEH) repair is challenging, with high recurrence rates reported. Evidence suggests that anterior gastropexy may reduce the recurrence rate, but real-world data are lacking. We performed a retrospective multicenter study of adults undergoing PEH repair (2018-2023) at four Scandinavian centers. The primary outcome was a computed tomograpy (CT) verified recurrence defined radiologically as a ≥20 mm herniation above the diaphragm. Propensity score matching balanced patients with and without anterior gastropexy. Outcomes and predictors were analyzed using matched comparisons and Cox proportional hazards regression. A total of 395 patients underwent primary PEH repair during the study period. The median age was 70 (range 63-76) years, and the median follow-up was 1.8 (0.8-3.3) years. 297 (75%) patients received a gastropexy as part of the procedure, while 98 (25%) patients did not. The group without gastropexy had a significantly higher rate of recurrence, 33 out of 98 patients (34%) compared with the gastropexy group, 45 out of 297 patients (15%, P < 0.001). After propensity score matching and adjustment for confounding factors, the risk of recurrence remained higher for patients who did not receive gastropexy (HR: 2.5, 95% CI: 1.3-4.9; P = 0.007). Anterior gastropexy was associated with a significantly lower risk of recurrence following PEH repair. These findings indicate that this component of the surgical procedure might improve long-term outcomes.
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