Biologic Prosthesis to Prevent Recurrence after Laparoscopic Paraesophageal Hernia Repair: Long-Term Follow-Up from a Multicenter, Prospective, Randomized Trial

2019 ◽  
pp. 11-12
Author(s):  
Fahim Habib
Keyword(s):  
Hernia Repair ◽  
Randomized Trial ◽  
Paraesophageal Hernia ◽  
Prospective Randomized Trial ◽  
Paraesophageal Hernia Repair ◽  
Long Term Follow Up ◽  
Laparoscopic Paraesophageal Hernia Repair

O168 VERY LONG-TERM (5-19 YEARS) FOLLOW-UP OF PARAESOPHAGEAL HERNIA REPAIR: PERMANENT MESH vs STANDARD CRUROPLASTY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Pamela Milito ◽  
Simone Zanghì ◽  
Andrea Sironi ◽  
Emanuele Asti ◽  
Luigi Bonavina
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Paraesophageal Hernia ◽  
Synthetic Mesh ◽  
Hernia Recurrence ◽  
Paraesophageal Hernia Repair ◽  
Long Term Follow Up ◽  
Large Hiatus Hernia

Abstract Aim Aim of this comparative study was to analyze very long-term safety, symptomatic outcomes and rate of recurrence in a cohort of patients who underwent large hiatus hernia repair with or without synthetic mesh. Background & Methods The use of a permanent mesh to reinforce the hiatus could reduce the rate of radiological and symptomatic recurrences after laparoscopic paraesophageal hernia repair. However, strictures and even erosions into the esophageal lumen have been reported. Aim of this comparative study was to analyze very long-term safety, symptomatic outcomes and rate of recurrence in a cohort of patients who underwent large hiatus hernia repair with or without synthetic mesh. Observational cohort study using a prospectively maintained database. From November 2001 to September 2005, 39 consecutive patients underwent laparoscopic repair and fundoplication for large hiatus hernia (> 5 cm). Thirteen patients (Group M) received crural reinforcement with non-absorbable mesh, while 26 patients (Group S) underwent standard cruroplasty. Mesh-related complications, postoperative symptoms and hernia recurrence at very long-term follow-up through upper gastrointestinal endoscopy, GERD-HRQL and FOREGUT questionnaires. Results There were 23 women and 16 men, with a median age of 60 years (range 28-81). The hernia size was similar in both groups. Postoperative complications occurred in 2 patients (5.1%) and there was no mortality. The median long-term follow-up was 168 months (range 139-197 months, IQR: 23.5). At last follow-up visit, occasional (once a month) dysphagia occurred in 23% of Group M patients, but none required endoscopic dilatation. The hernia recurrence rate was 0. No short or long-term complications related to the use of the mesh were recorded. In group S, non of patients, complained of dysphagia, whereas 2 (7.7%) patients complained of occasional reflux symptoms and other 2 (7.7%) of dyspepsia. In 4 patients (15.4%), a small hiatus hernia recurrence or a partially slipped fundoplication was noted, but all patients were asymptomatic. GERD-HRQL scores significantly decrease in both groups (p<0.05). Conclusion Laparoscopic antireflux surgery with permanent prosthetic mesh is an effective and safe procedure in carefully selected patients with large hiatal hernia.

scholarly journals Laparoscopic Paraesophageal Hernia Repair: Defining Long-Term Clinical and Anatomic Outcomes

2011 ◽  
Vol 140 (5) ◽  
pp. S-992
Author(s):  
Brant K. Oelschlager ◽  
Rebecca P. Petersen ◽  
L. Michael Brunt ◽  
Nathaniel J. Soper ◽  
Brett C. Sheppard ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Paraesophageal Hernia ◽  
Paraesophageal Hernia Repair ◽  
Laparoscopic Paraesophageal Hernia Repair

scholarly journals P141 USE OF POLYPROPYLENE STRIPS FOR REINFORCEMENT OF THE CRUROPLASTY IN LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR: A RETROSPECTIVE COHORT STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Matthijs Van den Dop ◽  
Gijs De Smet ◽  
Aziz Mamound ◽  
Johan Lange ◽  
Bas Wijnhoven ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Paraesophageal Hernia ◽  
Operation Time ◽  
Paraesophageal Hernia Repair ◽  
Primary Hernia ◽  
Laparoscopic Paraesophageal Hernia Repair ◽  
Crural Repair

Abstract Aim Laparoscopic paraesophageal hernia repair is an effective treatment for symptomatic paraesophageal hernias. To reduce recurrence rates, the use of prosthetics for the crural repair has been suggested. Mesh-related complications are rare, but known to be disastrous. To address another form of crural repair, polypropylene strips are suggested. This study aimed to assess peri- and postoperative complications of reinforcement of the cruroplasty with polypropylene strips. Material and Methods From 2013 to 2020, patients with a type II, III or IV primary or recurrent paraesophageal hernia that underwent cruroplasty with polypropylene strips were retrospectively reviewed. Intra- and postoperative complications were graded according to the Clavien-Dindo classification. The incidence of symptomatic recurrent hiatal hernia (CT or endoscopy proven) and hospital stay were assessed. Results One-hundred-and-fifty-eight patients were included. Mean age was 65 years (standard deviation 10.4), 119 patients were female (75.3%). Almost 50% of surgeries took place between 2018 and 2020. Median follow-up was 7 months (interquartile range 17.5). Mean operation time in the primary hernia group was 159 minutes (standard deviation 39.0), and length of stay was 4.4 days. In 3/158 patients (2.0%) intra-operative complications occurred. Two patients developed a grade IV and seven patients a grade III postoperative complication. No mortality was recorded. Twelve recurrences (8.2%) were detected in the primary hernia group, and one (9.1%) in the recurrent hernia group. Conclusions There were no mesh-related complications seen and symptomatic recurrence rate was low, but longer follow up is needed.

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