Mesh migration after hiatal hernia repair

Borráez-Segura, Bernardo; Mena, Manuel Jiménez; Bedoya, Santiago; Ramírez, Carlos Andrés Trejos; Anduquia, Felipe; Hurtado, Natalia; Bedoya, Hugo; Calvache, Carlos

doi:10.1007/s12664-019-00993-0

Cited by 4 publications

(1 citation statement)

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“…However, the overall complication rate was higher with nonabsorbable mesh (OR = 1.45; 95 % CI 1.24 -1.71; p < 0.01). [9] Doubts about the expediency of routine use of implants in the surgical treatment of PEH are reinforced by reports of complications associated with them: shrinkage, mesh migration [24,107,34], infection (abscesses, fistulas) [33,67], cardiac tamponade, erosion of the aorta [91], esophagus or stomach [75,2], esophageal stenosis [121], severe dysphagia, and fibrotic reaction that may complicate new esophageal surgery [122]. A recent survey of surgeons showed that 21 % and 25 % of respondents diagnosed mesh erosion and esophageal stenosis, respectively [57].…”

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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