“Is more better?”: association of intra-abdominal esophageal length in laparoscopic paraesophageal hernia repair with recurrent hiatal hernia

Recurrence of hiatal hernia after paraesophageal hernia repair (PEHR) affects many patients, and axial tension is thought to be a major factor. A widely accepted guideline is that extensive esophageal mobilization to achieve at least 3 cm of intra-abdominal esophageal length is important, and more length may further reduce recurrence, but there are minimal data to support this. We aimed to analyze the relationship between intra-abdominal esophageal length and recurrence in patients undergoing laparoscopic PEHR.