Influence Of Surgeon Practice Type On Recurrence After Paraesophageal Hernia Repair: A Retrospective Cohort Study

• Community repairs were associated with higher recurrence rates; however, community surgeons also treated an older and more medically complex patient population.

• Key Finding: Surgeon practice type, fellowship training, andvolume are critical determinants of long-term PEH repair durability. 

• Volume vs. Training: High case volume (>40/year) and fellowship training were the strongest protective factors against recurrence.

•  Safety Profile: PEH repair is performed safely across both academic and community settings, with no significant difference in 30-day morbidity.

•  Future Work: Prospective studies are needed to validate the impact of standardized training on community-based outcomes.