{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T14:19:21Z","timestamp":1784816361450,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Very large hiatus hernias are often symptomatic, impact quality of life, and are increasingly encountered in aging populations. Laparoscopic repair offers excellent clinical outcomes. However, surgeons can be reluctant to offer surgery to the elderly due to concerns about morbidity and mortality. To determine safety, we evaluated outcomes following repair of very large hiatus hernias in patients aged 80\u00a0years and older and compared them to younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were extracted from a prospective database. Patients who underwent operative repair of a very large hiatus hernia (&gt;\u00a050% intrathoracic stomach) between 2000 and 2023 were included and categorized into groups based on age: young (&lt;\u00a070\u00a0years), older (70\u201379\u00a0years), and octogenarian (\u2265 80\u00a0years). Perioperative and early postoperative clinical outcomes were determined and compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1353 patients underwent surgery (&lt;\u00a070\u00a0years: 733 [54.2%], 70\u201379\u00a0years: 451 [33.3%], and \u2265\u00a080\u00a0years: 169 [12.5%]). Rates of total intrathoracic stomach were commonest in octogenarians (11.6% vs. 20.4% vs. 32.5% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Young and older patients were more likely to undergo elective surgery for heartburn (56.6% vs. 44.4% vs. 29.0% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), whereas octogenarians more likely underwent emergency surgery for gastric volvulus (5.4% vs. 6.6% vs. 14.5% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019). Conversion to open surgery (1.1% vs. 1.1% vs. 5.0% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002) and length of stay (2.69 vs. 3.19 vs. 4.62\u00a0days and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) were greater in the octogenarian group. Major complications (4.2% vs. 5.1% vs. 8.1% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.120) and return to theater rates (2.6% vs. 2.9% vs. 2.7% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.925) were similar. Thirty\u2010day mortality rates were low for all groups but highest in octogenarians (0.3% vs. 0.4% vs. 1.8% and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.048). Adverse outcomes were more likely with emergency presentations, which were more common in octogenarians.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a higher rate of emergency surgery in octogenarians\u2014major complications and overall mortality rates are still acceptably low. Repair of very large symptomatic hiatus hernia should not be withheld from patients aged over 80 who are otherwise fit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.12569","type":"journal-article","created":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T11:48:36Z","timestamp":1744544916000},"page":"1237-1245","source":"Crossref","is-referenced-by-count":4,"title":["Safety and Early Clinical Outcomes Following Repair of Very Large Hiatus Hernia in Octogenarians"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-2203","authenticated-orcid":false,"given":"Mathew A.","family":"Amprayil","sequence":"first","affiliation":[{"name":"Flinders University Discipline of Surgery Flinders Medical Centre  Bedford Park Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Irvine","sequence":"additional","affiliation":[{"name":"Flinders University Discipline of Surgery Flinders Medical Centre  Bedford Park Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah K.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Flinders University Discipline of Surgery Flinders Medical Centre  Bedford Park Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Bright","sequence":"additional","affiliation":[{"name":"Flinders University Discipline of Surgery Flinders Medical Centre  Bedford Park Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7683-2693","authenticated-orcid":false,"given":"David I.","family":"Watson","sequence":"additional","affiliation":[{"name":"Flinders University Discipline of Surgery Flinders Medical Centre  Bedford Park Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010022\u201001705\u2010w"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2013.07.002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/jmas.JMAS_233_20"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010023\u201005829\u2010z"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2023.0019"},{"key":"e_1_2_8_7_1","unstructured":"Australian Bureau of Statistics Older Australians (2023). 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