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Outcomes of laparoscopic hiatal hernia repair based on surgical specialty: thoracic versus general surgeons

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Abstract

Background

Hiatal Hernia Repairs (HHR) are performed by both general surgeons (GS) and thoracic surgeons (TS). However, there are limited literature with respect to outcomes of HHR based on specialty training. The objective of this study was to compare the utilization, perioperative outcomes, and cost for HHR performed by GS versus TS.

Methods

The Vizient database was used to identify patients who underwent elective laparoscopic HHR between October 2014 and June 2018. Patients were grouped according to surgeon’s specialty (GS vs. TS). Patient demographics and outcomes including in-hospital mortality were compared between groups.

Results

During the study period 13,764 patients underwent HHR by either GS or TS. GS performed 9930 (72%) cases while TS performed 3834 (28%) cases. There was no significant difference between GS versus TS with regard to serious morbidity (1.28% vs. 1.30%, p = 0.97) or mortality (0.10% vs. 0.21%, p = 0.19). The mortality index was 0.24 for GS versus 0.45 for TS. Compared to TS, laparoscopic HHR performed by GS was associated with a shorter LOS (2.57 days vs. 2.72 days, p < 0.001) and lower mean hospital costs ($7139 vs. $8032, p < 0.0001).

Conclusions

Within the context of academic centers, laparoscopic HHRs are mostly performed by GS with comparable outcome between general versus thoracic surgeons.

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Correspondence to Ninh T. Nguyen.

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Disclosures

Ninh T. Nguyen received honorarium as a speaker for Covidien, Gore, Novadaq, and Olympus. Brian R. Smith received honorarium as an educational consultant for Stryker Endoscopy. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. All authors have approved the final article. Sahil Gambhir, Shaun Daly, Shelley Maithel, Brian M. Sheehan, James Nguyen, and Marcelo W. Hinojosa have no conflicts of interest or financial ties to disclose.

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Gambhir, S., Daly, S., Maithel, S. et al. Outcomes of laparoscopic hiatal hernia repair based on surgical specialty: thoracic versus general surgeons. Surg Endosc 34, 1621–1624 (2020). https://doi.org/10.1007/s00464-019-06926-4

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  • DOI: https://doi.org/10.1007/s00464-019-06926-4

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