Long-term results and complications related to Crurasoft® mesh repair for paraesophageal hiatal hernias

Priego, Pablo; Oteyza, Joaquín Pérez de; Álvarez, Julio Galindo; Carda, Pedro; García-Moreno, Francisca; Velasco, Gloria; Lobo, Eduardo

doi:10.1007/s10029-016-1486-6

Cited by 19 publications

(12 citation statements)

References 23 publications

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“…HH repair commonly includes the following four steps: hernia sac peeling and resection, mobilization of esophagus, repair of crus diagram, and fundoplication [28,29]. The use of mesh in crural repair has not been widely accepted, but when used, the absorbable mesh is most commonly selected [30][31][32]. Zhang et al [33] confirmed that mesh repair may be associated with fewer short-term recurrences and that biological mesh was associated with improved short-term QOL; however, these advantages were offset by increased instances of dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

2020

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Background: Hiatal hernia is defined by the permanent or intermittent prolapse of any abdominal structure into the chest through the diaphragmatic esophageal hiatus. Prolapse of the stomach, intestine, transverse colon, and spleen is relatively common, but herniation of the pancreas is a rare condition. We describe a case of acute pancreatitis and bile duct dilatation secondary to a massive hiatal hernia of pancreatic body and tail. Case presentation: An 86-year-old woman with hiatal hernia who complained of epigastric pain and vomiting was admitted to our hospital. Blood tests revealed a hyperamylasemia and abnormal liver function test. Computed tomography revealed prolapse of the massive hiatal hernia, containing the stomach and pancreatic body and tail, with peripancreatic fluid in the posterior mediastinal space as a sequel to pancreatitis. In addition, intrahepatic and extrahepatic bile ducts were seen to be dilated and deformed. After conservative treatment for pancreatitis, an elective operation was performed. There was a strong adhesion between the hernial sac and the right diaphragmatic crus. After the stomach and pancreas were pulled into the abdominal cavity, the hiatal orifice was closed by silk thread sutures (primary repair), and the mesh was fixed in front of the hernial orifice. Toupet fundoplication and intraoperative endoscopy were performed. The patient had an uneventful postoperative course post-procedure. Conclusion: A rare massive hiatal hernia, involving the stomach and pancreatic body and tail, can cause acute pancreatitis with bile duct dilatation. The etiology can be flexure of the main pancreatic and extrahepatic bile ducts. Symptomatic herniation is best treated with surgery. Elective surgery is thought to be safer than emergent surgery in patients with serious complications.

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Section: Discussionmentioning

confidence: 99%

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

2020

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“…При ýтом частота анатомических рецидивов составила 4,0% [14]. Однако в более позднем исследовании ýтих же авторов на 93 пациентах и послеоперационным наблюдением в среднем через 76 мес, частота анатомических рецидивов составила 9,0%, частота реопераций -5,4%, сетка была удалена в трех случаях [15].…”

Section: политетрафторэтиленовые имплантатыunclassified

Complications and relapses after alloplasty of large and giant hernia of the esophageal aperture of the diaphragm

Розенфельд¹

2019

Bûll. sib. med.

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The review of the literature presents the content analysis of surgical treatment of large and giant hernia of the esophageal aperture of the diaphragm as well as the analyses of complications when using the main methods of hernioplasty. Alloplasty of the esophageal aperture of the diaphragm remains a large and unresolved surgical problem, as evidenced by the analyzed literature sources, mainly reviews and clinical recommendations.Firstly, alloplasty can cause postoperative complications with a frequency of up to 20%, especially when using rigid polypropylene and composite polytetrafluoroethylene mesh implants with circular paraesophageal fixation. Modern biological nets now show high incidence of anatomical relapses, so most specialists continue to use synthetic implants, of which the most promising ones are lightweight, mesh, partially absorbable structures.Secondly, clear indications for alloplasty have not been developed, for example, according to the size of the hernia of the esophageal opening in the diaphragm, which is the main risk factor for relapses.Thirdly, it is still not clear what indicator should be used to estimate the size of hernia of the esophageal aperture of the diaphragm and, therefore, it is not clearly defined which hernias are considered small, which are large and which are giant, despite the fact that the three terms constantly appear in the medical literature.Fourthly, the optimal technique for alloplasty has not been determined with large and especially giant hernias, which would prevent anatomical relapses, and at the same time would not cause postoperative complications.It is necessary to outline the following ways to solve these problems: to develop effective and at the same time safe methods of alloplasty of large and giant hernias; to determine clear indications for alloplasty of the esophageal opening of the diaphragm, depending on the size of hernias; to create an appropriate, applied classification of hernias of the esophageal aperture of the diaphragm.

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“… 14 , 15 Also, mesh-related complications have been reported, including intraluminal mesh erosion, dysphagia, esophageal stenosis, stricture formation, mesh migration, and dense fibrosis. 16 – 18 …”

Section: Introductionmentioning

confidence: 99%

Paraesophageal Hiatal Hernia Repair With Urinary Bladder Matrix Graft

Howell¹,

Fazzari

Petrone³

et al. 2018

JSLS

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Background and Objectives:Paraesophageal hiatal hernia repair can be performed with or without mesh reinforcement. The use, technique, and mesh type remain controversial because of mixed reports on mesh-related complications. Short-term outcomes have become important in all forms of surgery.Methods:From January 2012 through April 2017, all patients who underwent isolated hiatal hernia repair in our center were reviewed. Concomitant bariatric surgery cases were excluded. Repairs reinforced by porcine urinary bladder matrix (UBM) graft were compared to non-UBM repairs. Statistical comparison was based on a Wilcoxon 2-sample test or Fisher's exact test.Results:We reviewed 239 charts; 110 bariatric cases and 8 cases with non-UBM reinforcement were excluded. We identified 121 patients: 56 UBM-reinforced (46.3%) versus 65 non-UBM (53.7%). Sixteen (28.6%) UBM cases were male versus 23 (35.4%) non-UBM cases. The UBM patients were significantly older (63.9 versus 54.3; P = .001). There was no difference in mean BMI (29.6 vs 28.5; P = .28). Cases were performed laparoscopically (60.7% vs 67.7%; P = .45) or robotically (39.3% vs 32.3%; P = .45), with no conversions to open. The UBM group had a longer mean operative time (183 minutes vs 139 minutes; P = .001).There was no difference in median length of stay (2 days vs 2 days; P = .09) or 30-day readmission rate (7.1% vs 7.5%; P =.99). Postoperative complications were graded according to the Clavien-Dindo classification, and there was no difference (19.6% vs 9.2%; P = .12).Conclusions:Hiatal hernia repair with UBM reinforcement can be performed safely with no increase in postoperative complications.

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Long-term results and complications related to Crurasoft® mesh repair for paraesophageal hiatal hernias

Cited by 19 publications

References 23 publications

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

Complications and relapses after alloplasty of large and giant hernia of the esophageal aperture of the diaphragm

Paraesophageal Hiatal Hernia Repair With Urinary Bladder Matrix Graft

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