Defining Clinically Significant Radiographic Recurrence after Paraesophageal Hernia Repair: Post Hoc Analysis of Patient-Reported Outcomes and Reoperation from a Randomized Controlled Trial.
William C Bennett, Ryan C Ellis, Mahamed O Mohamed et al.
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In 30 seconds
This post hoc analysis of a randomized controlled trial evaluated the correlation between radiographic recurrence size and reoperation rates as well as patient-reported outcomes in adults undergoing minimally invasive paraesophageal hernia repair. Among 174 patients, reoperation occurred in 2.5%, with no reoperations for recurrences less than 2 cm, and rates of 7.5% and 23.1% for 2-5 cm and over 5 cm recurrences, respectively (p < 0.0001).
Key findings
- Reoperation rates were 0% for recurrences <2 cm, 7.5% for 2-5 cm, and 23.1% for >5 cm (p < 0.0001).
- Median GERD Health-Related Quality of Life scores were significantly worse for recurrences >2 cm compared to 0 cm.
- Total Foregut-Associated Symptoms Likert scores differed across recurrence groups (p = 0.019).
Why it matters
Understanding the relationship between recurrence size and clinical outcomes can help clinicians define thresholds for intervention after paraesophageal hernia repair, potentially improving patient management and quality of life.