ArticleSurgical endoscopy2026
Too old to operate? Retrospective outcomes of laparoscopic paraesophageal hernia repair in nonagenarians.
Article 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.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe majority of paraesophageal hernias (PEH) present in patients > 65 years old. We have previously reported the safety of laparoscopic paraesophageal hernia repair (LPEHR) in these patients. However, information regarding outcomes of LPEHR in nonagenarians is scant. Surgical mortality in nonagenarians has been reported as high as 20%. Many referring providers are reluctant to refer elderly patients for LPEHR because they believe the surgical risk is prohibitive. We designed this study to evaluate LPEHR outcomes at our institution in nonagenarians, elective vs non-elective.
methodsA single-institution retrospective cohort study of patients who underwent LPEHR January 1, 2003, to July 1, 2025, was performed in patients ≥ 90 years old at the time of surgery. Descriptive statistics and univariate analysis were performed to analyze the differences in patients undergoing elective vs non-elective repair. Non-elective repair was defined as presentation to the emergency department and/or transfer from outside institution with repair during that same hospitalization.
resultsA total of 34 patients age ≥90 (mean 92.32), predominantly female (70.59%), underwent LPEHR; 10 undergoing elective repair and 24 undergoing non-elective repair. Non-elective cases resulted in more ICU admissions (11, 45.83% vs 1, 10.0%), higher 30-day mortality (4, 16.67% vs 1, 10%), significantly longer length of stay (6.88 days vs 4.50 days, p = 0.03), and higher complication rates (12, 50.0% vs 1, 10.0%). Reoperations were similar. There was no significant difference between elective and non-elective patient discharge back to home after LPEHR (5, 50.0% vs 13, 54.17%).
conclusionOperative repair of PEH in the elderly remains safe and effective with better outcomes when done electively. To our knowledge, this is the largest study to evaluate LPEHR outcomes in nonagenarians. Referral to foregut surgeons should be considered regardless of age, at the time of identification of a symptomatic PEH, as elective repair shows the best outcomes.
Indexed as
Identifiers
42637943What OpenQuestion holds
Registered trials
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.