Video Experimental Relacionado

Updated: Mar 1, 2026

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh

Published on: September 11, 2021

Elevación de la recurrencia temprana de hernias paraesofágicas en pacientes con EPOC: Un análisis comparativo de

William Head¹, Divyaam Satija¹, Stefanie Rohde¹

¹Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University Wexner Medical Center.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

|February 27, 2026

Abstracto

Background:

Chronic Obstructive Pulmonary Disease (COPD) increases surgical morbidity and mortality, but its impact on paraesophageal hernia repair (PEHR) is unknown. This study evaluated associations between COPD and PEHR outcomes, hypothesizing an increased risk of hernia recurrence in COPD patients.

Methods:

A retrospective cohort study (2011-2022) was conducted on elective PEHR patients, stratified into COPD and High-Risk Non-COPD groups (ASA class 3 or 4). The primary outcome was early recurrence (<6 months). Propensity score matching (1:1) controlled for age, sex, and BMI. Chi-Squared and Mann-Whitney U tests compared demographics and outcomes. Kaplan-Meier curves analyzed recurrence timing, and multivariable logistic regression assessed COPD as an independent risk factor, adjusting for age, BMI, ASA class, and smoking status.

Results:

Among 537 patients, 62 matched pairs were analyzed. COPD was not linked to increased respiratory complications but was associated with higher discharge to advanced care (12.9% vs. 1.6%; p=0.038) and earlier recurrence (160 vs. 652 days; p=0.01). Kaplan-Meier curves showed increased early recurrence in COPD patients (p=0.02), though recurrence rates converged later. COPD independently predicted early recurrence (OR 4.4; p<0.001).

Conclusion:

COPD is an independent risk factor for early recurrence after PEHR, though it does not increase respiratory complications or overall recurrence. COPD patients more frequently required higher-level care and experienced earlier recurrence. These findings may guide shared decision-making and suggest strategies like routine mesh placement to mitigate recurrence risk.

Palabras clave:

Enfermedad pulmonar obstructiva crónica Hernia paraesofágica Recurrencia

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