Does a Biologic Prosthesis Really Reduce Recurrence After Laparoscopic Paraesophageal Hernia Repair?

Oelschlager, Brant K.; Nelson, James; Mitsumori, Lee M.; Hunter, John G.; Sheppard, Brett C.; Jobe, Blair A.; Soper, Nathaniel J.; Brunt, Michael; Pollisar, Nayak; Swanström, Lee L.

doi:10.1097/sla.0b013e31815c29d9

Cited by 18 publications

(31 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…14 Another study also noted that at short-term follow-up, there was an improvement in the score from baseline, however, there was no reported statistically significant difference between the mesh and sutured repair groups. 22 A long-term follow-up of this RCT also concluded the same: that there was an improvement from baseline but no statistically significant difference between the groups. 26 The final study also found that all of study groups showed a difference in the physical and mental component scores from baseline to shortterm follow-up, but there were no significant differences between the study groups at short-term follow-up.…”

Section: Quality Of Lifementioning

confidence: 55%

“…The database search retrieved 394 publications, including 7 RCTs, 14,18,[21][22][23][24][25] from 2002 to 2020 which met the inclusion criteria, and a further 2 studies containing later follow up data from 2 of the RCTs which were also included in the meta-analysis. The PRISMA flow chart for the literature search is shown in Figure 1.…”

Section: Included Studiesmentioning

confidence: 99%

“…Figure S1, http://links.lww.com/SLA/D74 summarizes the potential sources of bias for the RCTs, with all falling into ''low risk'' of bias for most of categories. Four of the 7 studies were limited by a lack of description of the randomization and/or blinding processes in the methods, 18,[21][22][23] whereas this was explicit in 3 of the 7 RCTs. 14,24,25…”

Section: Bias Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Sutured Versus Mesh-augmented Hiatus Hernia Repair

et al. 2021

View full text Add to dashboard Cite

Objective: This meta-analysis systematically reviewed published randomized control trials comparing sutured versus mesh-augmented hiatus hernia (HH) repair. Our primary endpoint was HH recurrence at short- and long-term follow-up. Secondary endpoints were: surgical complications, operative times, dysphagia and quality of life. Summary Background Data: Repair of large HHs is increasingly being performed. However, there is no consensus for the optimal technique for hiatal closure between sutured versus mesh-augmented (absorbable or nonabsorbable) repair. Methods: A systematic review of Medline, Scopus (which encompassed Embase), Cochrane Central Register of Controlled Trials, Web of Science, and PubMed was performed to identify relevant studies comparing mesh-augmented versus sutured HH repair. Data were extracted and compared by meta-analysis, using odds ratio and mean differences with 95% confidence intervals. Results: Seven randomized control trials were found which compared mesh-augmented (nonabsorbable mesh: n = 296; absorbable mesh: n = 92) with sutured repair (n = 347). There were no significant differences for short-term hernia recurrence (defined as 6–12 months, 10.1% mesh vs 15.5% sutured, P = 0.22), long-term hernia recurrence (defined as 3–5 years, 30.7% mesh vs 31.3% sutured, P = 0.69), functional outcomes and patient satisfaction. The only statistically significant difference was that the mesh repair required a longer operation time (P = 0.05, OR 2.33, 95% confidence interval 0.03–24.69). Conclusions: Mesh repair for HH does not offer any advantage over sutured hiatal closure. As both techniques deliver good and comparable clinical outcomes, a suture only technique is still an appropriate approach.

show abstract

Section: Quality Of Lifementioning

confidence: 55%

Section: Included Studiesmentioning

confidence: 99%

Section: Bias Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Sutured Versus Mesh-augmented Hiatus Hernia Repair

et al. 2021

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7][8] Reinforcement of the esophageal hiatus with a mesh has been advocated to reduce such recurrence rates. [9][10][11][12] However, some studies have questioned the usefulness of prosthetic reinforcement, 11,[13][14][15] and others have even risen major concerns regarding mesh-related complications (eg, infection, migration, stenosis, erosion of the esophagus or stomach). 16,17 The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines on the management of hiatal hernia recommend the use of mesh for the repair of large hernias.…”

mentioning

confidence: 99%

Laparoscopic Paraesophageal Hernia Repair

Angeramo

Schlottmann

2021

Annals of Surgery

View full text Add to dashboard Cite

Objective: This study aimed to compare outcomes after laparoscopic paraesophageal hernia repair (LPEHR) with mesh or primary repair alone. Summary of Background Data: High recurrence rates after LPEHR have been reported. Whether the use of mesh improves outcomes remains elusive. Methods: A systematic literature search was performed to identify randomized controlled trials (RCTs) comparing LPEHR with mesh repair versus suture repair alone. Early (≤6 months) and late (>6 months) recurrence rates were used as primary endpoints to assess efficacy. Intraoperative complications, overall morbidity, and reoperation rates were used as secondary endpoints to assess safety. A meta-analysis was conducted using relative risks (RR) with 95% confidence intervals (CI) for the analyzed outcomes. Results: Seven RCTs comparing mesh (n = 383) versus suture only (n = 352) repair were included for analysis. Patients undergoing LPEHR with mesh reinforcement had similar early (RR = 0.74, 95% CI = 0.26–2.07, P = 0.46) and late (RR = 0.75, 95% CI = 0.27–2.08, P = 0.48) recurrence rates as those with primary repair. Similar recurrence rates were also found when stratifying the analysis by the type of mesh utilized (absorbable and nonabsorbable). Intraoperative complications (RR = 1.03, 95% CI = 0.33–3.28, P = 0.92) and reoperation rates (RR = 0.75, 95% CI = 0.29–1.92, P = 0.45) were also similar in both groups. Overall morbidity, however, was higher after mesh repair with nonabsorbable mesh (RR = 1.45, 95% CI = 1.24–1.71, P < 0.01) Conclusions: Patients undergoing LPEHR have similar early and late recurrence rates with either mesh reinforcement or suture only repair, regardless of the type of mesh utilized. Overall morbidity, however, seems to be higher in patients repaired with nonabsorbable mesh.

show abstract

“…1,3 Mesh repair has been shown to have decreased recurrence rates, and the introduction of biologic meshes has decreased mesh-related complications. 4 Emergent repair of GPEH is reserved for patients with signs of strangulation, obstruction, bleeding, or respiratory compromise. Given the complexity of this case, the concern for underlying malignancy, as well as the massively distended colon, we performed our reduction and resection through traditional laparotomy.…”

mentioning

confidence: 99%

Giant Paraesophageal Hernia With Obstructing Splenic Flexure Mass in the Left Hemithorax

Fleming

Scheckel

Harmon

et al. 2021

The American Surgeon™

View full text Add to dashboard Cite

Giant paraesophageal hernias contain greater than fifty percent of the stomach above the diaphragm. Over fifty percent of large bowel obstructions are due to colorectal adenocarcinoma. Here, we present a rare case of a 69-year-old female patient who developed a closed loop colonic obstruction caused by a colonic mass in the distal transverse colon within a giant paraesophageal hernia. We successfully performed emergent paraesophageal hernia reduction and mesh repair with extended right hemicolectomy and ileocolonic anastomosis. Emergent hernia repair via an abdominal approach can be used in this setting.

show abstract

Does a Biologic Prosthesis Really Reduce Recurrence After Laparoscopic Paraesophageal Hernia Repair?

Cited by 18 publications

References 3 publications

Sutured Versus Mesh-augmented Hiatus Hernia Repair

Sutured Versus Mesh-augmented Hiatus Hernia Repair

Laparoscopic Paraesophageal Hernia Repair

Giant Paraesophageal Hernia With Obstructing Splenic Flexure Mass in the Left Hemithorax

Contact Info

Product

Resources

About