Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias

Schmidt, Elizabeth; Shaligram, Abhijit; Reynoso, Jason F.; Kothari, Vishal; Oleynikov, Dmitry

doi:10.1111/dote.12042

Cited by 44 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most patients with a recurrent paraesophageal hernia still experience an improvement of clinical symptoms compared to the preoperative status ( 63 , 64 ). Despite the high recurrence rate up to 54% after a laparoscopic repair of the hiatus with or without mesh, there can be a significant improvement in all parameters assessing the quality of life ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Since the mesh can be placed in at least six different positions, the best placement is still unknown. Most surgeons place a mesh in a U-shape or a pantaloon collar in a retroesophageal position with the limbs of the mesh encircling the esophagus [Table 2 ( 10 – 64 )]. Data depicted in Figures 8 and 9 indicate a different behavior of synthetic and biologic meshes when the esophagus is not fully encircled.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Functional Results after Repair of Large Hiatal Hernia by Use of a Biologic Mesh

2016

View full text Add to dashboard Cite

BackgroundThe aim of this observational study is to analyze the results of patients with large hiatal hernia and upside-down stomach after surgical closure with a biological mesh (Permacol®, Covidien, Neustadt an der Donau, Germany). Biological mesh is used to prevent long-term detrimental effects of artificial meshes and to reduce recurrence rates.MethodsA total of 13 patients with a large hiatal hernia and endothoracic stomach, who underwent surgery between 2010 and 2014, were included. Interviews and upper endoscopy were conducted to determine recurrences, lifestyle restrictions, and current complaints.ResultsAfter a mean follow-up of 26 ± 18 months (range: 3–58 months), 10 patients (3 men, mean age 73 ± 13, range: 26–81 years) were evaluated. A small recurrent axial hernia was found in one patient postoperatively. Dysphagia was the most common complaint (four cases); while in one case, the problem was solved after endoscopic dilatation. In three cases, bloat and postprandial pain were documented. In one case, an explantation of the mesh was necessary due to mesh migration and painful adhesions. In one further case with gastroparesis, pyloroplasty was performed without success. The data are compared to the available literature. It was found that dysphagia and recurrence rates are unrelated both in biological and in synthetic meshes if the esophagus is encircled. In series preserving the esophagus at least partially uncoated, recurrences after the use of biological meshes relieve dysphagia. After the application of synthetic meshes, dysphagia is aggravated by recurrences.ConclusionRecurrence is rare after encircling hiatal hernia repair with the biological mesh Permacol®. Dysphagia, gas bloat, and intra-abdominal pain are frequent complaints. Despite the small number of patients, it can be concluded that a biological mesh may be an alternative to synthetic meshes to reduce recurrences at least for up to 2 years. Our study demonstrates that local fibrosis and thickening of the mesh can affect the outcome being associated with abdominal discomfort despite a successful repair. The review of the literature indicates comparable results after 2 years with both biologic and synthetic meshes embracing the esophagus. At the same point in time, reconstruction with synthetic and biologic materials differs when the esophagus is not or only partially encircled in the repair. This is important since encircling artificial meshes can erode the esophagus after 5–10 years.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional Results after Repair of Large Hiatal Hernia by Use of a Biologic Mesh

2016

View full text Add to dashboard Cite

show abstract

“…One case did have to get converted from laparoscopic to open for dense adhesions. While some advocate that an anti-reflux procedure is not necessary [13], it is our practice to routinely perform an anti-reflux procedure at the time of our PEH repair. As seen in Fig.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of radiologic recurrence after paraesophageal hernia repair with mesh

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Most authors have focused their interest on potential beneficial effects of biologic grafts in paraesophageal hernia. In a cohort study, Schmidt and colleagues compared suture repair and mesh augmentation with HACD in small hernias (1–5 cm as assessed by barium upper gastrointestinal series or esophagogastroscopy) ( 36 ). A benefit of mesh repair was demonstrated, as indicated by a reduced recurrence rate (16 vs. 0%) at 1 year and improvement of symptoms of dysphagia.…”

Section: Resultsmentioning

confidence: 99%

The Use of Biological Meshes in Diaphragmatic Defects – An Evidence-Based Review of the Literature

Antoniou¹,

Pointner²,

Granderath³

et al. 2015

Front. Surg.

View full text Add to dashboard Cite

The widespread use of meshes for hiatal hernia repair has emerged in the era of laparoscopic surgery, although sporadic cases of mesh augmentation of traumatic diaphragmatic rupture have been reported. The indications for biologic meshes in diaphragmatic repair are ill defined. This systematic review aims to investigate the available evidence on the role of biologic meshes in diaphragmatic rupture and hiatal hernia repair. Limited data from sporadic case reports and case series have demonstrated that repair of traumatic diaphragmatic rupture with biologic mesh is safe technique in both the acute or chronic setting. High level evidence demonstrates short-term benefits of biologic mesh augmentation in hiatal hernia repair over primary repair, although adequate long-term data are not currently available. Long-term follow-up data suggest no benefit of hiatal hernia repair using porcine small intestine submucosa over suture repair. The effectiveness of different biologic mesh materials on hernia recurrence requires further investigation.

show abstract

Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias

Cited by 44 publications

References 34 publications

Functional Results after Repair of Large Hiatal Hernia by Use of a Biologic Mesh

Functional Results after Repair of Large Hiatal Hernia by Use of a Biologic Mesh

Long-term outcomes of radiologic recurrence after paraesophageal hernia repair with mesh

The Use of Biological Meshes in Diaphragmatic Defects – An Evidence-Based Review of the Literature

Contact Info

Product

Resources

About