Prosthetic Mesh Repair of Large and Recurrent Diaphragmatic Hernias

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2007 Apr 27

PMID 17458615

Citations 12

Authors

Nir Lubezky

Boaz Sagie

Andrei Keidar

Amir Szold

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic repair of large paraesophageal hernias (PEH) is associated with significant recurrence rates. Use of prosthetic mesh to complete tension-free repair of the hiatus has been suggested to decrease the recurrence rate.

Methods: Fifty-nine patients with large (n = 44) or recurrent (n = 15) PEH were operated on via the laparoscopic approach with the use of prosthetic mesh. Patients were followed with office visits and phone interviews. All patients were referred for barium studies. Data analysis included all patients, including conversions, on an intention-to-treat basis.

Results: Followup was completed in 56 (95%) patients. Mean followup time was 28.4 months. Forty patients (74%) had significant relief of all symptoms. Barium studies were performed in 45 patients (80.3%), including all symptomatic patients. Fifteen patients (33%) had a small sliding hernia, six (13.3%) had recurrent PEH, and four (8.8%) had narrowing of the gastroesophageal junction. Most patients with small hiatal hernias were symptomatic (60%). All responded to medical treatment.

Conclusions: Laparoscopic repair of large PEH with reinforcement mesh is feasible and safe with excellent short-term results. Long-term followup shows a low PEH recurrence requiring reoperation, but a significant number of patients develop symptomatic recurrent small hiatal hernias that can be managed nonoperatively.

Citing Articles

Total versus partial posterior fundoplication in the surgical repair of para-oesophageal hernias: randomized clinical trial.

Analatos A, Lindblad M, Ansorge C, Lundell L, Thorell A, Hakanson B BJS Open. 2022; 6(3).

PMID: 35511051 PMC: 9070466. DOI: 10.1093/bjsopen/zrac034.

Hiatal hernia repair: prevention of mesh erosion and migration into the esophagogastric junction.

Braghetto I, Korn O, Rojas J, Valladares H, Figueroa M Arq Bras Cir Dig. 2020; 33(1):e1489.

PMID: 32428134 PMC: 7236328. DOI: 10.1590/0102-672020190001e1489.

[Hiatus hernia : Standards and controversies in diagnostics and treatment].

Weyhe D, Uslar V, Kuhne J, Kluge A Chirurg. 2019; 90(4):331-348.

PMID: 30903226 DOI: 10.1007/s00104-019-0932-2.

A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication.

Castelijns P, Ponten J, van de Poll M, Nienhuijs S, Smulders J J Minim Access Surg. 2017; 14(2):87-94.

PMID: 28928334 PMC: 5869985. DOI: 10.4103/jmas.JMAS_91_17.

Laparoscopic repair of giant paraesophageal hernia: are there factors associated with anatomic recurrence?.

Antiporda M, Veenstra B, Jackson C, Kandel P, Smith C, Bowers S Surg Endosc. 2017; 32(2):945-954.

PMID: 28733735 DOI: 10.1007/s00464-017-5770-z.

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