A commentary on ‘Intraoperative endomanometric laparoscopic Nissen fundoplication improves postoperative outcomes in large sliding hiatus hernias with severe gastroesophageal reflux disease: a retrospective cohort study’
Abstract
Gastroesophageal re fl ux disease (GERD) is a disease that occurs in the esophagus or beyond due to the re fl ux of gastric contents [1] . Esophageal hiatal hernia, most commonly type I sliding hiatal hernia (HH), is one of the leading causes of GERD [2] . Laparoscopic Nissen fundoplication (LNF) is currently recognized as the preferred surgery for the treatment of GERD [3] . Habeeb et al . [4] conducted a retrospective multicenter cohort study designed to assess the impact of intraoperative endoscopy and intraoperative manometry in improving prognosis after LNF. The authors clearly de fi ned the concepts of severe GERD (DeMeester score > 100) and large sliding hiatal hernias (HHs) ( > 5 cm). The design of this study, which focused on the intraoperative use of high-resolution manometry (HRM) and endoscopy to improve surgical outcomes and patient satisfaction, is commendable as it attempts a less-explored area in GERD. However, there are still some limitations:
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use
- Ivth brazilian consensus conference on helicobacter pylori infection
- A pSMAD/CDX2 complex is essential for the intestinalization of epithelial metaplasia
- S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – März 2023 – AWMF-Registernummer: 021–013
- Step-by-step management of refractory gastresophageal reflux disease
- Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger–Ellison Syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.