{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:00Z","timestamp":1787008680006,"version":"build-2736575974"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,30]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Large hiatus hernias with a significant paraesophageal component (types II\u2013IV) have a range of insidious symptoms. Management of symptomatic hernias includes conservative treatment or surgery. Currently, there is no paraesophageal hernia disease-specific symptom questionnaire. As a result, many clinicians rely on the health-related quality of life questionnaires designed for gastro-esophageal reflux disease (GORD) to assess patients with hiatal hernias pre- and postoperatively. In view of this, a paraesophageal hernia symptom tool (POST) was designed. This POST questionnaire now requires validation and assessment of clinical utility. Twenty-one international sites will recruit patients with paraesophageal hernias to complete a series of questionnaires over a five-year period. There will be two cohorts of patients\u2014patients with paraesophageal hernias undergoing surgery and patients managed conservatively. Patients are required to complete a validated GORD-HRQL, POST questionnaire, and satisfaction questionnaire preoperatively. Surgical cohorts will also complete questionnaires postoperatively at 4\u20136\u00a0weeks, 6\u00a0months, 12\u00a0months, and then annually for a total of 5\u00a0years. Conservatively managed patients will repeat questionnaires at 1\u00a0year. The first set of results will be released after 1 year with complete data published after a 5-year follow-up. The main results of the study will be patient\u2019s acceptance of the POST tool, clinical utility of the tool, assessment of the threshold for surgery, and patient symptom response to surgery. The study will validate the POST questionnaire and identify the relevance of the questionnaire in routine management of paraesophageal hernias.<\/jats:p>","DOI":"10.1093\/dote\/doad028","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T15:02:21Z","timestamp":1683730941000},"source":"Crossref","is-referenced-by-count":1,"title":["Research protocol for the Paraesophageal hernia symptom tool, a prospective multi-center cohort study to identify the need and threshold for surgery and assess the symptom response to surgery"],"prefix":"10.1093","volume":"36","author":[{"given":"Nainika","family":"Menon","sequence":"first","affiliation":[{"name":"Department of general surgery, Oxford University Hospitals National Health Service Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Guidozzi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swathikan","family":"Chidambaram","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, St Mary\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiysha","family":"Puri","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, St Mary\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viknesh","family":"Sounderajah","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, St Mary\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Ferri","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Centre , Montreal, Quebec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewen A","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Department of Surgery, Univeristy of Birmingham National Health Service Trust , Birmingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Centre , Seattle, Washington , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Maynard","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oxford Upper GI Centre, Churchill Hospital, Oxford University Hospitals National Health Service Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Thoracic Oncology, Virginia Mason Medical Centre , Seattle, Washington , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Pera","sequence":"additional","affiliation":[{"name":"Section of Gastrointestinal Surgery , Department of Surgery, , Barcelona , Spain"},{"name":"Hospital del Mar Medical Research Institute , Department of Surgery, , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I","family":"van Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Division of Surgery, UMC Amsterdam , Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine and Public Health, Flinders University , Adelaide , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Zaininotto","sequence":"additional","affiliation":[{"name":"Department of Surgery , Hospital SS Giovanni e Paolo, Venezia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George B","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London, St Mary\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheraz R","family":"Markar","sequence":"additional","affiliation":[{"name":"Department of general surgery, Oxford University Hospitals National Health Service Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"2024011514213826200_ref1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.athoracsur.2005.02.019","article-title":"Open repair of paraesophageal hernia: reassessment of subjective and objective outcomes","volume":"80","author":"Low","year":"2005","journal-title":"Ann Thorac 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