title: Acute paraesophageal hernia repair: short-term outcome comparisons with elective repair.
abstract: BACKGROUND
  In the literature, there is a wide range of reported morbidity and mortality rates after acute paraesophageal hernia (PH) repair.
  
  
  METHODS
  Data were collected from all patients undergoing PH repair between December 2001 and October 2011. Outcome data were compared between the acute and elective groups.
  
  
  RESULTS
  Over the study period, 268 patients underwent PH repair, of which 42 patients underwent acute repair compared with 226 elective repairs. Morbidity and mortality rates were both higher, albeit nonsignificantly, in the acute group (16.6% vs. 6.6%, P=0.058 and 4.8% vs. 0.4%, P=0.065, respectively).
  
  
  CONCLUSIONS
  Because of the poorer preoperative medical status, lower success rates of minimal access surgery, and longer inpatient stay, combined with the trends toward increased morbidity and mortality rates, of patients undergoing acute repair of PH, we would recommend routine elective laparoscopic surgery as the standard of care for individuals with symptomatic PH and minimal comorbidities.
authors.affiliation: *Department of Upper Gastrointestinal Surgery †Gastrointestinal Investigation Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia.
authors.forename: Ralph F
authors.initials: RF
authors.lastname: Staerkle
authors.forename: Richard J E
authors.initials: RJ
authors.lastname: Skipworth
authors.forename: Ross D
authors.initials: RD
authors.lastname: Hansen
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hazebroek
authors.forename: Garett S
authors.initials: GS
authors.lastname: Smith
authors.forename: Steven
authors.initials: S
authors.lastname: Leibman
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome