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Table 2 Review of literature

From: Minimally invasive laparoscopic and robot-assisted emergency treatment of strangulated giant hiatal hernias: report of five cases and literature review

Article Patients1 Age, sex2 Emergent indication BMI3 ASA Type of hernia Use of mesh Additional surgery Hospital stay4 Main complications Recurrences
Dubina [24] 266/3334 68 ± 14, 71% male Obstruction or gangrene n.a. I–II (40%), III–IV (60%)a n.a. n.a. n.a. 5 ± 7 Overall morbidity (11%), pneumonia (4%)a n.a.
Shea [25] 30/229 74 ± 13, 80% male Volvulus (47%), bleeding (17%), obstruction (20%), heart/respiratory failure (13%) 29 ± 6 II (23%), III (67%), IV (10%) III (67%), IV (33%) Acellular porcine liver derived (100%) Nissen (100%), gastrostomy (13%), gastric resections (23%) 7 ± 6 Overall morbidity (47%) 17%
Zanotti [26] 1/4 73, female Volvulus n.a. n.a. III Synthetic partially absorbable Nissen 7 Pneumonia No
Arevalo [27] 4/13 85 ± 9, sex n.a. Bleeding (25%), obstruction (100%) n.a. III (50%), IV (50%) n.a. None Gastropexy and gastrostomy (100%) 7 (2–14) Reoperation for early recurrence (25%) No
Augustin [28] 56/3498 71, 36% male SIRS/sepsis/septic shock (30%)b 26 (25-28)b III–IV (22%)b n.a. n.a. n.a. 9 (7-10)b Infections (7%), sepsis/shock (8%), reoperation (9%), heart/lung complications (28%), others (7%)b n.a.
Light [29] 9/36 73c Gastric volvulus (100%)c n.a. III–IV (73%)c n.a. None (no hiatal repair in 11%)c Dor (22%), Nissen (8%), gastropexy (31%), gastric resections (11%)c 4 Pneumonia (25%), others (11%)c 2%
Klinginsmith [30] 1358/7950 65 ± 14, 48% maled n.a. n.a. n.a. n.a. n.a. Fundoplication (38%), gastrostomy (12%) n.a. Overall morbidity (8%) n.a.
Köhler [31] 3/24 64 ± 14, 42% malee Obstruction (100%) n.a. n.a. n.a. Synthetic (75%)e Toupet (25%), Nissen (75%), gastropexy n.a. Pneumonia (33%), splenic bleeding (33%) 1%e
Jassim [32] 2896/41723 66, 35% malef n.a. Obesity (7%)f n.a. n.a. n.a. n.a. n.a. Overall morbidity (33%)f n.a.
Mungo [33] 116/8186 63 ± 14, 28% maleg n.a. < 25 (18%), 25–29.9 (27%), ≥ 30 (45%)g II (56%), III (43%), IV (2%)g n.a. n.a. n.a. 3 ± 5g Overall morbidity (8%), reoperation (3%), pneumonia (2%), sepsis/shock (1%), heart/lung complications (4%)g n.a.
Gebhart [34] 3/92 57 ± 14, 40% male h Incarceration n.a. n.a. IV (2%)h Biosynthetic (some cases) Nissen (73%)h 2 ± 3h Overall morbidity (6%)h 19%h
Parker [35] 25/266 75 (51–91), 12% male Obstruction, haemorrhage, perforation, sepsis from gastric ischemia 30 n.a. II (4%), III (92%), IV (4%) Synthetic or acellular human dermal matrix (85%) Nissen or Dor (76%), Collis (24%) 4 (1–13) Overall morbidity (52%), heart/lung complications (24%), pneumonia (4%), infections (4%), leak (12%) 4%
Ballian [36] 24/980 < 50 (15%), 50–59 (12%), 60–69 (10%), 70–79 (17%), ≥ 80 (47%), 25% malei n.a. Underweight (44%), ideal (32%), overweight (17%), obese (15%), severely obese (15%)i n.a. n.a. Unpecified (12%)j Dor or Toupet (21%), Nissen (70%), Collis (47%)j n.a. Overall morbidity (23%), pneumonia (7%), heart/lung complication (18%), sepsis/shock (2%), leak (2%)j 1%j
Shaikh [37] 11/64 68 ± 2, 25% male n.a. n.a. n.a. n.a. Porcine small intestine submucosa matrix used in 3 cases unspecified if emergent/elective, laparoscopic/open Fundoplication (65%), gastropexy (13%), gastropexy only (25%)k 6 ± 2††† Overall morbidity (23%)k 25%k
Louie [38] 9/58 78 (70–91), 41% malel Incarceration (100%) n.a. n.a. II (5%), III (78%), IV (17%)l Biologic (38%) Nissen (31%), Hill (33%), combined Nissen and Hill (34%), gastrostomy (2%)l n.a. Lung complications (11%) 11%
Bawahab [39] 17/20 71 (49–91), 15% malem Obstruction, bleeding, respiratory failure n.a. n.a. n.a. Porcine small intestine submucosa matrix (6%) Nissen or Dor (100%) 7 (2–15) 0% n.a.
Parameswaran [40] 5/49 68 (38–90), 41% malen n.a. n.a. III–IV (41%)n II (10%), III (73%), IV (16%)n PFTE or composite (22%), porcine small intestine submucosa matrix (12%)n Nissen (100%), gastropexy in some casesn n.a. Overall morbidity (24%)n 8%‡‡‡
Hortsmann [41] 16 64 (36–80), 50% male Obstruction 29 (19–31) II (31%), III (69%) n.a. Polypropylene (100%) Toupet (100%), gasropexy (100%) 9 (7–23) Lung complications (31–38%) 0%
  1. BMI body mass index, ASA American Society of Anaesthesiologists, n.a. not available, SIRS systemic inflammatory response syndrome, PFTE polytetrafluoroethylene
  2. aData available for the entire group of patients treated laparoscopically: 2473 patients, 266 treated in emergency setting
  3. bData available for the entire group of patients treated in emergency setting: 175 patients, 56 undergoing laparoscopic repair
  4. cData available for the entire group of patients treated for gastric volvulus: 36 patients, 9 undergoing laparoscopic repair
  5. dData available for the entire group of patients treated in emergency setting: 6726 patients, 1358 undergoing laparoscopic repair
  6. eData available for the entire group of studied patients
  7. fData available for the entire group of patients treated in emergency setting: 10,765 patients, 2896 undergoing laparoscopic repair
  8. gData available for the entire group of patients treated laparoscopically: 6415 patients, 116 treated in emergency setting
  9. hData available for the entire group of studied patients
  10. iData available for the entire group of patients treated non-electively: 199 patients, 24 undergoing laparoscopic repair
  11. jData available for the entire group of studied patients: 980 patients, 199 treated non-electively
  12. kData available for the entire group of patients treated laparoscopically: 40 patients, 11 treated in emergency setting
  13. lData available for the entire group of studied patients
  14. mData available for the entire group of studied patients
  15. nData available for the entire group of studied patients
  16. 1Number of patients treated in emergency setting and laparoscopically/total number of patients studied
  17. 2Mean ± standard deviation or median (range) for age expressed in years; percentage of male patients
  18. 3Mean ± standard deviation of BMI expressed in kg/m2
  19. 4Mean ± standard deviation or median (range) for hospital stay expressed in days