ArticleSurgical endoscopy2025
Outcomes of elective repair of large hiatus hernias in the morbidly obese: a cohort study.
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.
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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.
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Who cites it
2 citing papers in PubMed.
- Association between mesh reinforcement and postoperative gastroparesis following paraesophageal and hiatal hernia repair: a propensity-matched analysis.Surgical endoscopy · 2026Article
- Obesity is not associated with increased adverse outcomes following paraesophageal hernia repair.Surgical endoscopy · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObesity is a risk factor for the development of a large hiatus hernia. Such hernias are often symptomatic and negatively impact quality of life. However, surgeons can be reluctant to operate on obese patients due to concerns of operative complexity, early hernia recurrence, and increased morbidity. To evaluate this, we assessed the perioperative risks and short-term outcomes following surgery in obese and morbidly obese patients.
methodsPatients who underwent repair of a large hiatus hernia (≥50% intrathoracic stomach) from January 2000 to December 2023 were identified from a prospective database. Patients were categorised based on body mass index (BMI) into 3 groups: non-obese (BMI < 30.0), obese (BMI 30.0-34.9), and morbidly obese (BMI ≥ 35.0). Perioperative and postoperative outcomes were compared.
results915 patients were included (non-obese: 519 [56.7%], obese: 276 [30.1%], morbidly obese: 120 [13.1%]). Morbidly obese patients were younger (69.2 vs 65.8 vs 64 years, p < 0.001) and more likely to be female (60.9 vs 79.7 vs 83.9%, p < 0.001). There were no differences in conversion rates (0.8 vs 0.7 vs 1.7%, p = 0.592), operative time (106.4 vs 103.4 vs 113.6 min, p = 0.074), or length of stay (2.8 vs 2.48 vs 2.57 days, p = 0.063). We found no differences in major complication (4.0 vs 2.9 vs 1.7%, p = 0.435) or return to theatre rates (2.7 vs 1.1 vs 1.7%, p = 0.475). 90-day mortality rates were low for all groups (0.2 vs 0.4 vs 0%). Postoperative heartburn severity was lowest in non-obese patients (0.94 vs 1.86 vs 1.21, p = 0.010). There were no differences in postoperative regurgitation severity (1.02 vs 1.30 vs 1.74, p = 0.185) or overall satisfaction (8.74 vs 8.62 vs 8.91, p = 0.702).
conclusionLarge hiatus hernia repair is safe and effective in obese and morbidly obese populations.
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