Accepted Manuscript Thirty-Day Outcomes of Paraesophageal Hernia Repair Using the NSQIP Database: Should Laparoscopy Be the Standard of Care? Benedetto Mungo, MD Daniela Molena, MD, FACS Miloslawa Stem, MS Richard L. Feinberg, MD, FACS Anne O. Lidor, MD, MPH, FACS PII:
S1072-7515(14)00323-8
DOI:
10.1016/j.jamcollsurg.2014.02.030
Reference:
ACS 7368
To appear in:
Journal of the American College of Surgeons
Received Date: 10 October 2013 Revised Date:
24 February 2014
Accepted Date: 25 February 2014
Please cite this article as: Mungo B, Molena D, Stem M, Feinberg RL, Lidor AO, Thirty-Day Outcomes of Paraesophageal Hernia Repair Using the NSQIP Database: Should Laparoscopy Be the Standard of Care?, Journal of the American College of Surgeons (2014), doi: 10.1016/j.jamcollsurg.2014.02.030. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Thirty-Day Outcomes of Paraesophageal Hernia Repair Using the NSQIP Database: Should Laparoscopy Be the Standard of Care?
Benedetto Mungo, MD ¶, Daniela Molena, MD, FACS ¶, Miloslawa Stem, MS*, Richard L Feinberg,
Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of
SC
¶
RI PT
MD, FACS*, Anne O Lidor, MD, MPH, FACS*
M AN U
Medicine, Baltimore, MD
*Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
Disclosure Information: Nothing to disclose.
Support: Mr Edwin Lewis provided generous support of Dr Lidor’s Department of Surgery research
TE D
fund.
Presented at the American College of Surgeons 99th Annual Clinical Congress, Washington,
EP
DC, October 2013.
AC C
Correspondence address: Benedetto Mungo, M.D. Division of Thoracic Surgery Department of Surgery Johns Hopkins University 600 N Wolfe Street, Blalock 240 Baltimore, MD 21287 Office: (410) 614 3891 Fax: (410) 614 9428 E-mail: [email protected]
Brief title: Outcomes of Paraesophageal Hernia Repair
1
ACCEPTED MANUSCRIPT Abstract
Background: Although surgical repair is universally recognized as the gold standard for treatment of paraesophageal hernia (PEH), the optimal surgical approach is still the subject of debate. To
RI PT
determine which surgical technique is safest, we compared the outcomes of laparoscopic (lap), open trans-abdominal (TA) and open trans-thoracic (TT) PEH repair using the NSQIP database.
SC
Study Design: From 2005 to 2011, we identified 8,186 patients who underwent a PEH repair (78.4% lap, 19.2% TA, 2.4% TT). Primary outcome measured was 30-day mortality. Secondary outcomes
M AN U
included length of stay (LOS), and NSQIP-measured post-operative complications. Multivariable analyses were performed to compare the odds of each outcome across procedure type (lap, TA, and TT) while adjusting for other factors.
TE D
Results: TA patients had the highest 30-day mortality rate (2.6%), compared to 0.5% in the lap patients (p
S1072-7515(14)00323-8
DOI:
10.1016/j.jamcollsurg.2014.02.030
Reference:
ACS 7368
To appear in:
Journal of the American College of Surgeons
Received Date: 10 October 2013 Revised Date:
24 February 2014
Accepted Date: 25 February 2014
Please cite this article as: Mungo B, Molena D, Stem M, Feinberg RL, Lidor AO, Thirty-Day Outcomes of Paraesophageal Hernia Repair Using the NSQIP Database: Should Laparoscopy Be the Standard of Care?, Journal of the American College of Surgeons (2014), doi: 10.1016/j.jamcollsurg.2014.02.030. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Thirty-Day Outcomes of Paraesophageal Hernia Repair Using the NSQIP Database: Should Laparoscopy Be the Standard of Care?
Benedetto Mungo, MD ¶, Daniela Molena, MD, FACS ¶, Miloslawa Stem, MS*, Richard L Feinberg,
Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of
SC
¶
RI PT
MD, FACS*, Anne O Lidor, MD, MPH, FACS*
M AN U
Medicine, Baltimore, MD
*Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
Disclosure Information: Nothing to disclose.
Support: Mr Edwin Lewis provided generous support of Dr Lidor’s Department of Surgery research
TE D
fund.
Presented at the American College of Surgeons 99th Annual Clinical Congress, Washington,
EP
DC, October 2013.
AC C
Correspondence address: Benedetto Mungo, M.D. Division of Thoracic Surgery Department of Surgery Johns Hopkins University 600 N Wolfe Street, Blalock 240 Baltimore, MD 21287 Office: (410) 614 3891 Fax: (410) 614 9428 E-mail: [email protected]
Brief title: Outcomes of Paraesophageal Hernia Repair
1
ACCEPTED MANUSCRIPT Abstract
Background: Although surgical repair is universally recognized as the gold standard for treatment of paraesophageal hernia (PEH), the optimal surgical approach is still the subject of debate. To
RI PT
determine which surgical technique is safest, we compared the outcomes of laparoscopic (lap), open trans-abdominal (TA) and open trans-thoracic (TT) PEH repair using the NSQIP database.
SC
Study Design: From 2005 to 2011, we identified 8,186 patients who underwent a PEH repair (78.4% lap, 19.2% TA, 2.4% TT). Primary outcome measured was 30-day mortality. Secondary outcomes
M AN U
included length of stay (LOS), and NSQIP-measured post-operative complications. Multivariable analyses were performed to compare the odds of each outcome across procedure type (lap, TA, and TT) while adjusting for other factors.
TE D
Results: TA patients had the highest 30-day mortality rate (2.6%), compared to 0.5% in the lap patients (p
