Evidence map›Paper›PMID 42377526›Full record

SynthesisSurgical endoscopy2026

Comparison of outcomes of minimally invasive vs. open surgery in patients with symptomatic hiatal hernias: a systematic review and meta-analysis.

Vanessa Ha, Aayush R Malhotra, Veronica Pentland, Jessica Nguyen, Boris Zevin, Robert Bechara, Andrew Giles, Kenneth Reid, Wiley Chung

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Vanessa HaSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Aayush R MalhotraSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada. Amalhotra@qmed.ca.ORCID http://orcid.org/0009-0006-4051-565X
Veronica PentlandSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Jessica NguyenSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Boris ZevinSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Robert BecharaDivision of Gastroenterology, Queen's University, Kingston, Ontario, Canada.
Andrew GilesSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Kenneth ReidSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.
Wiley ChungSchool of Medicine, Faculty of Health Science, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo conduct a systematic review and meta-analysis of studies that compared minimally invasive surgery (MIS) to open surgery on postoperative outcomes in patients with symptomatic hiatal hernia (HH).

backgroundEarly literature raised questions about whether MIS was associated with higher HH recurrence rates compared to open surgery. Previous systematic reviews comparing the two approaches did not formally address recurrence as an outcome.

methodsSearches were conducted in MEDLINE, EMBASE, and reference lists up to June 13th, 2024. English-language studies comparing MIS (laparoscopy and robotic-assisted) to open surgery (laparotomy and thoracotomy) in symptomatic HH patients were eligible. A generic inverse variance using fixed-effects meta-analysis was performed. Evidence quality was assessed using GRADE.

resultsThe analysis included 21 studies (n = 184,381). No randomized controlled trials were identified. MIS was not associated with increased risk of hiatal hernia recurrence (RR = 0.87 [95% CI: 0.57, 1.33]; p = 0.52; GRADE: very low) and was associated with lower 30-day mortality (RR = 0.21 [0.15, 0.29]; p < 0.0001; GRADE: low), wound infection (RR = 0.24 [0.18, 0.32]; p < 0.00001; GRADE: very low), and shorter hospital stay (MD = -4.44 [- 4.69, - 4.20]; p < 0.00001; GRADE: low). CONCLUSIONS AND RELEVANCE: MIS compared to open surgery was not associated with an increased risk of HH recurrence and was associated with a lower risk of 30-day mortality, wound infection, and shorter hospital stays. Evidence quality ranged from low to very low. Higher quality studies are needed to confirm the current findings. PROSPERO REGISTRATION: CRD42020164419.

Indexed as

Hernia, HiatalHerniorrhaphyLaparoscopyLaparotomyMinimally Invasive Surgical ProceduresRobotic Surgical ProceduresThoracotomyHumansLength of StayPostoperative ComplicationsRecurrenceTreatment OutcomeHiatal herniaHiatal hernia repairMinimally invasive surgeryOpen surgeryRecurrence

Identifiers

PMID42377526

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.