632 Sutured Versus Mesh-Augmented Hiatus Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Petric, Josipa; Bright, Tim; Liu, David; Wee, Melissa; Watson, David I.

doi:10.1093/dote/doab052.632

Cited by 10 publications

(18 citation statements)

References 27 publications

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“…Petric et al 27 also made an effort to pool the analyses of current RCTs and studies with longer term outcomes. They pooled the results of 7 RCTs comparing suture versus mesh augmented repairs of the hiatal hernia.…”

Section: Long Term Outcomesmentioning

confidence: 99%

Short and Long Term Outcomes of Paraesophageal Hernia Repair

Massie

Auyang

2022

Foregut: The Journal of the American Foregut Society

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This review will attempt to highlight some of the short- (1-2 years) and long-term (>5 years) outcomes of paraesophageal hernia repairs (PEHR), demonstrating that despite the significant incidence of radiographic recurrence for surgical correction of PEH, many patients continue to have durable relief from their previous symptoms. This supports the current indications for PEHR surgery and highlights an interesting discordance between radiographic recurrence and the initial defect encountered during evaluation. Major limitations in research will be outlined, such as the difficulty of following these patients for extended periods given the extremes of age at which this condition typically presents. Finally, much of this review will focus on elective laparoscopic PEHR, as this is now the accepted modality and setting for initially treating a symptomatic PEH due to superior effects on post-operative pain, morbidity, and recovery by experienced surgeons.

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Section: Long Term Outcomesmentioning

confidence: 99%

Short and Long Term Outcomes of Paraesophageal Hernia Repair

Massie

Auyang

2022

Foregut: The Journal of the American Foregut Society

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“…In 2022, Petric J. et al [104] analyzed seven randomized controlled trials (RCTs) comparing mesh cruroplasty of the EH (non-absorbable mesh: n = 296; absorbable mesh: n = 92) with suture crurorrhaphy (n = 347). The authors found no significant differences between the groups regarding short-term hernia recurrence (within 6 -12 months): 10.1 % with mesh versus 15.5 % with suture crurorrhaphy, p = 0.22; and long-term hernia recurrence: within 3 -5 years, 30.7 % with mesh versus 31.3 % with suture crurorrhaphy, p = 0.69.…”

Section: T a Tarasov L Y Markulanmentioning

confidence: 99%

“…The only statistically significant difference was that mesh placement required a longer operating time. The authors of the meta-analysis concluded that both methods provided good and comparable clinical results, with the suture-only method still being the relevant approach [104].…”

Section: T a Tarasov L Y Markulanmentioning

confidence: 99%

Paraesophageal hernia: the state of the problem and controversial issues. Review

Tarasov

Markulan²

2022

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The literature review focuses on the controversial issues regarding the treatment of paraesophageal hernia. The limitations of the current classification of hiatal hernias are highlighted. It is irrelevant and does not meet clinical needs. Objective criteria for its improvement are proposed. Data on the prevalence and course of hiatal hernias are given. Their pathogenetic factors and diagnostic methods are underlined. Considerable emphasis is placed on the paraesophageal hernia treatment strategies in patients with an asymptomatic and mildly symptomatic clinical course of the disease. Arguments are presented in favour of both wait‑and‑see tactics and planned hernioplasty. The choice of hernioplasty technique, especially in the case of giant hernias, the feasibility and indications for the use of mesh implants depending on their shape and composition, and the potential complications of allogenioplasty are the main topics for discussion. The problem of selecting a fundoplication method is addressed while weighing the advantages and potential side effects of employing various fundoplication modifications. The effects of correcting a short esophagus and eliminating the axial pressure on the esophageal hiatus are thoroughly evaluated, as these conditions increase the risk of hernia recurrence. The authors concluded that there are many controversial issues in the treatment of paraesophageal hernia. A consensus is needed on the classification of paraesophageal hernias, which would meet the urgent needs of choosing the method of operative delivery, and, in particular, the definition of the concepts of «large hernia» and «giant hernia.» Further research is required on issues such as the indications for operative treatment of paraesophageal hernias, especially in the case of asymptomatic large hernias and incarcerated hernias; the feasibility of using implants for plastic surgery of the esophageal hiatus; the choice of a fundoplication method; the diagnosis and correction of a short esophagus; and methodology for evaluating long‑term treatment outcomes.

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“…This study confirms the results of many other studies that have shown that a cruroplasty with sutures is as effective as a cruroplasty reinforced by either absorbable or nonabsorbable mesh. [3][4][5] Some aspects of this article deserve comments. Most of the studies mentioned in the discussion evaluated the use of mesh for the repair of large paraesophageal hernias, a different disease and a more complex operation, [3][4][5][6] whereas in this study, only patients mostly with small sliding hernias were included.…”

mentioning

confidence: 99%