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Enregistrement W3198550448 · doi:10.1016/j.xjtc.2021.08.043

Commentary: Paraesophageal hernia repair: Don't slip up

2021· editorial· en· W3198550448 sur OpenAlexaboutno aff
Nidhi Desai, Thomas Ng

Notice bibliographique

RevueJTCVS Techniques · 2021
Typeeditorial
Langueen
DomaineMedicine
ThématiqueGastroesophageal reflux and treatments
Établissements canadiensnon disponible
Organismes subventionnairesnon disponible
Mots-clésMedicineHernia repairHerniaGeneral surgeryLaparoscopySurgeryHiatal herniaInternal medicine

Résumé

récupéré en direct d'OpenAlex

Central MessageRecurrence rates after repair of paraesophageal hernia continues to be high. Surgeons should adhere to all components of the repair and perform each with great attention to detail.See Article page 497. Recurrence rates after repair of paraesophageal hernia continues to be high. Surgeons should adhere to all components of the repair and perform each with great attention to detail. See Article page 497. Repair of paraesophageal hernia has evolved greatly since its earliest description in 1919.1Stylopoulos N. Rattner D.W. The history of hiatal hernia surgery: from Bowditch to laparoscopy.Ann Surg. 2005; 241: 185-193Crossref PubMed Scopus (108) Google Scholar Open thoracic approaches have made way to minimally invasive techniques by laparoscopy; however, recurrence rates have been high, reportedly up to 60%.2Laliberte A.S. Louie B.E. Short-term and long-term outcomes of paraesophageal hernia repair.Thorac Surg Clin. 2019; 29: 405-414Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Although most recurrences are radiographic, with rates of revision surgery being much lower, this high rate indicates that the surgical community still needs to improve. The current Video Atlas article provided to us by Alicuben and colleagues3Alicuben E.T. Luketich J.D. Levy R.M. Laparoscopic repair of giant paraesophageal hernia.J Thorac Cardiovasc Surg Tech. 2021; 10: 497-502Scopus (3) Google Scholar is a detailed description of the operative technique used at the University of Pittsburgh Medical Center to achieve a successful and durable repair of paraesophageal hernias. The components of the repair need not be restated here, as they are clearly explained and demonstrated by the authors. Needless to say, each of these components are of vital importance to the repair and should be meticulously performed, without short cuts or compromise. The surgeons at the University of Pittsburgh Medical Center have long been leaders in the field of minimally invasive foregut surgery. Luketich and colleagues4Luketich J.D. Nason K.S. Christie N.A. Pennathur A. Jobe B.A. Landreneau R.J. et al.Outcomes after a decade of laparoscopic giant paraesophageal hernia repair.J Thorac Cardiovasc Surg. 2010; 139: 395-404Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar had previously published their results of giant paraesophageal hernia repair by laparoscopy, reporting a radiographic recurrence rate of 15.7% and a reoperative rate for recurrence of 3.2%. These results are comparable with the often-quoted benchmark set by Maziak and colleagues5Maziak D.E. Todd T.R. Pearson F.G. Massive hiatus hernia: evaluation and surgical management.J Thorac Cardiovasc Surg. 1998; 115: 53-60Abstract Full Text Full Text PDF PubMed Scopus (208) Google Scholar at the University of Toronto of 2.2% with transthoracic repair. It is unlikely that the “Holy Grail” of zero recurrence after paraoesophageal hernia repair will ever be attained; the hiatus is a dynamic region under constant stress and strain, but the recurrence rates still appear to be high. It is imperative to show the medical community that we can do much better; surgeons should honestly evaluate their recurrence rates and, if high, improve their technique. This Video Atlas article by Alicuben and colleagues3Alicuben E.T. Luketich J.D. Levy R.M. Laparoscopic repair of giant paraesophageal hernia.J Thorac Cardiovasc Surg Tech. 2021; 10: 497-502Scopus (3) Google Scholar provides the perfect start; it is indeed a must-read (must-view) for surgeons of all levels who seek to tackle the repair of such a complex region. As a final thought, it has been more than a decade since Luketich and colleagues4Luketich J.D. Nason K.S. Christie N.A. Pennathur A. Jobe B.A. Landreneau R.J. et al.Outcomes after a decade of laparoscopic giant paraesophageal hernia repair.J Thorac Cardiovasc Surg. 2010; 139: 395-404Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar first published their outstanding results with laparoscopic repair of giant paraesophageal hernia. As the authors have shown, the development of new techniques is of paramount importance toward reducing morbidity for our patients. Hopefully, the authors continue to review and share their results for the more recent cohort to elucidate a promising trend for decreased recurrence rates. Laparoscopic repair of giant paraesophageal herniaJTCVS TechniquesVol. 10PreviewFeature Editor's Introduction—Secondary to its intricacies and complexities, “benign esophageal surgery” is often considered its own surgical field, composed primarily of antireflux surgery, esophageal motility surgery, and surgery of the esophageal hiatus. Giant paraesophageal hernias are hiatal hernias in which greater than one third of the stomach is intrathoracic and their repair is arguably one of the most complex “benign esophageal” procedures. They are large (by definition), can contain multiple abdominal viscera, and may necessitate additional esophageal lengthening procedures. Full-Text PDF Open Access

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,000
score de la tête « metaresearch » (Gemma)0,000
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesMéta-épidémiologie (sens strict), Intégrité de la recherche
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Sans objet · Signal consensuel: Sans objet
GenreSignal candidat: Éditorial · Signal consensuel: Éditorial
Score de désaccord entre enseignants0,034
Score d'incertitude au seuil1,000

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0000,000
Méta-épidémiologie (sens strict)0,0010,001
Méta-épidémiologie (sens large)0,0010,001
Bibliométrie0,0000,000
Études des sciences et des technologies0,0000,000
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0020,002
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,010
Tête enseignante GPT0,310
Écart entre enseignants0,300 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Devis d'étudeSans objet
Domainenon disponible
GenreÉditorial

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations0
Publié2021
Routes d'admission1
Résumé présentoui

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