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10.1007/s00464-025-12398-6 http://scihub22266oqcxt.onion/10.1007/s00464-025-12398-6 41359171!?!41359171 Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=41359171&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215       Surg+Endosc 2025 ; ? (?): ? Nephropedia Template TP {{tp|p=41359171|t=2025. Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients |pdf=|usr=}}{{41359171}} gab.com Text Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients JO: Surg Endosc http://www.kidney.de/pget.php?&tw=1&pmid=41359171 #FOAvip BACKGROUND: The management of patients with acute paraesophageal hernia (APEH) remains to be standardized. This study evaluates the safety and outcomes of a novel staged approach for patients with APEH, which is based on gastric decompression followed by non-operative management and either emergency or semi-elective surgical treatment when deemed necessary. STUDY DESIGN: Observational study of a consecutive case series of APEH patients admitted to the hospital between 2007 and 2024, with a minimum follow-up of 3 months. All patients were managed according to the staged approach. Clinical outcomes including postoperative complications, recurrence, and readmission rates were assessed. RESULTS: Fifty-eight patients (70.7% women) with a mean age of 81 +/- 9.2 years (20.7% of patients aged over 90 years) and significant comorbidities were included. Early decompression via nasogastric tube and/or esophagogastroduodenoscopy relieved symptoms in 81% of cases, avoiding emergency surgery. Surgery was deemed unsuitable for 15 patients of whom 4 died due to acute complications, while 11 were successfully managed non-operatively. Surgical intervention was performed in 43 patients (74.1%) primarily through laparoscopic fundoplication, 10 of whom required urgent procedures. Compared to semi-elective repair, urgent surgery was associated with a higher rate of major postoperative complications (40% vs. 21.2%). Over a median follow-up of 27 months, 5 patients (11.6%) required readmission within a 90-day period and 3 (7%) experienced hernia recurrence. None of the patients died. CONCLUSION: A staged approach for the management of APEH was feasible, with definitive repair achieved in 93% of surgical patients, via laparoscopy in 72% of cases, and without perioperative mortality. Twit Text FOAVip Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients ????Surg Endosc http://www.kidney.de/pget.php?&tw=1&pmid=41359171 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=41359171 #FOAvip English Wikipedia <ref>{{Cite pmid|41359171}}</ref> Tailored staged approach for acute paraesophageal hernia: safe and effective in high-risk patients #MMPMID41359171 Biel E; Jaume-Bottcher S; Montcusi B; Sanchez-Parrilla J; Manterola C; Grande L; Pera M Surg Endosc 2025[Dec]; ? (?): ? PMID41359171show ga BACKGROUND: The management of patients with acute paraesophageal hernia (APEH) remains to be standardized. This study evaluates the safety and outcomes of a novel staged approach for patients with APEH, which is based on gastric decompression followed by non-operative management and either emergency or semi-elective surgical treatment when deemed necessary. STUDY DESIGN: Observational study of a consecutive case series of APEH patients admitted to the hospital between 2007 and 2024, with a minimum follow-up of 3 months. All patients were managed according to the staged approach. Clinical outcomes including postoperative complications, recurrence, and readmission rates were assessed. RESULTS: Fifty-eight patients (70.7% women) with a mean age of 81 +/- 9.2 years (20.7% of patients aged over 90 years) and significant comorbidities were included. Early decompression via nasogastric tube and/or esophagogastroduodenoscopy relieved symptoms in 81% of cases, avoiding emergency surgery. Surgery was deemed unsuitable for 15 patients of whom 4 died due to acute complications, while 11 were successfully managed non-operatively. Surgical intervention was performed in 43 patients (74.1%) primarily through laparoscopic fundoplication, 10 of whom required urgent procedures. Compared to semi-elective repair, urgent surgery was associated with a higher rate of major postoperative complications (40% vs. 21.2%). Over a median follow-up of 27 months, 5 patients (11.6%) required readmission within a 90-day period and 3 (7%) experienced hernia recurrence. None of the patients died. CONCLUSION: A staged approach for the management of APEH was feasible, with definitive repair achieved in 93% of surgical patients, via laparoscopy in 72% of cases, and without perioperative mortality. ?Tailored staged approach for acute paraesophageal hernia: safe and eff(epmc).pdf DeepDyve Pubget Overpricing