{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:23:39Z","timestamp":1787315019428,"version":"build-2736575974"},"reference-count":25,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergent paraesophageal hernia repair (emPEHR) may be required due to complications such as incarceration or gastric volvulus. However, data regarding changes in management and outcomes of emPEHR is limited. Our objective was to evaluate national trends in emPEHR over an 8-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2015-2022 ACS-NSQIP databases were queried for cases of emPEHR using Current Procedural Terminology (CPT) codes. Trends in patient demographics, operative characteristics, and 30-day postoperative outcomes were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 42\u00a0476 cases of PEHR were performed during the study period. Of these, 1583 (3.7%) were emergent. The proportion of emPEHR cases has increased from 2015 to 2022 (3.1% to 5.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Utilization of laparoscopy has increased from 60.3% to 79.1% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Emergent cases had a higher likelihood of wound (OR 4.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), pulmonary (OR 4.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), neurovascular (OR 3.9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), renal (OR 2.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and cardiac (OR 2.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) complications, sepsis (OR 6.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), reoperation (OR 1.9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), readmission (OR 1.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and mortality (OR 4.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) compared to elective cases. However, between, there was a decrease in renal complications (6.9% to 1.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004) and bleeding requiring transfusions (6.9% to 3.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) following emPEHR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>There has been an increase in rates of emergent PEHR since 2015. Emergent cases have poorer outcomes compared to elective cases, with only a minimal decrease in certain postoperative complications over time. This data highlights the importance of elective repair for PEHs and the need to proactively identify patients who will benefit from elective repair or specialist referral.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251376682","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T17:35:27Z","timestamp":1757784927000},"page":"7-14","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["National Trends in Emergent Paraesophageal Hernia Repair Over 8 Years"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9618-7634","authenticated-orcid":false,"given":"Ashley","family":"Tran","sequence":"first","affiliation":[{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Lipham","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Shiraga","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2007.12.007"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2019.00015"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/ales-23-71"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.01.017"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2013.07.002"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006119"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.71921"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08415-z"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm-21-1495"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5089-1"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-022-01705-w"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-017-3469-z"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4429-1"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0262019"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox084"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab013"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10640"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2024.5009"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2020.07.003"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.07.002"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.47717\/turkjsurg.2021.5267"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1106-1"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3626-3"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2011.0340"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-022-02744-w"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251376682","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251376682","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251376682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:25Z","timestamp":1777379905000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251376682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,13]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00031348251376682"],"URL":"https:\/\/doi.org\/10.1177\/00031348251376682","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,13]]}}}