• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Non-Elective Paraesophageal Hernia Repair: A Comparison of Surgical Approach and 30-day Outcomes using NSQIP

William C Sherrill, MD, Brent D Matthews, MD, Caroline E Reinke, MD, MSHP. Carolina Medical Center

Background: Over the past decade with the continuing increase of minimally invasive surgery (MIS) techniques, complex MIS procedures such as laparoscopic paraesophageal hernia (PEH) repair are on the rise.  The majority of these hernia repairs are being performed in the elective setting, however a subset of these are still being performed in a non-elective setting.  We aimed to determine the utilization of laparoscopic surgery in non-elective procedures and to compare outcomes with laparoscopy versus the open abdominal and thoracic outcomes.  We hypothesized that patients undergo non-elective laparoscopic paraesophageal hernias would have decreased mortality and 30-day outcomes compared to non-elective open abdominal or thoracic approaches.

Methods: The American College of Surgeons, National Surgical Quality Improvement Program (ACS NSQIP) 2011-2016 Database was queried for ICD-10 codes associated with paraesopahgeal hernia repairs (43332, 43333, 43281, 43282, 43335, 43336 and 43337).  Patient undergoing no-elective procedures were identified and classified by surgical approach. We compared preoperative patient characteristics, operative characteristics, discharge destination, and 30-day postoperative complication rates by surgical approach.  Logistic regression was used to examine the impact of operative approach on death or serious morbidity (DSM) and 30-day mortality.

Results: A total of 2,198 patients were found to have undergone non-elective paraesophageal hernia repair.  73% of these were done laparoscopically, 24% with an abdominal approach, and 2% were done through a thoracic-based approach.  Over the 6-year study period, there was an increase in the percentage of MIS approaches from 72% to 81%, with an accompanying decrease in abdominal approaches 25% to 18%.  Overall mortality was 6% in the abdominal approach, 3% in the laparoscopic approach and 7% in the thoracic approach  (p<0.01).  Utilization of a laparoscopic approach was found to be associated with a lower odds of mortality, decreased length of stay, and decreased odds of surgical site infections.  When compared to open abdominal surgery, using multivariable regression analysis,  MIS approach was found to have a statistically significant decreased odds of mortality (OR=0.43).  This was also found when examining the impact of an MIS approach on surgical site infections and mortality (OR=0.31 and OR=0.27 respectively).

Conclusions: Over the 6 years studied, an increasing percentage of non-elective paraesophageal hernia repairs are being performed in a minimally invasive fashion.  Using data from NSQIP we observed decreased mortality, decreased hospital length of stay and decreased surgical site infections when MIS techniques were used. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93791

Program Number: S067

Presentation Session: Residents and Fellows Session

Presentation Type: ResFel

56

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons