4.5 Article

Tension-free hiatal hernia repair with biological mesh A real-world experience

Journal

MEDICINE
Volume 101, Issue 45, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000031782

Keywords

biological mesh; fundoplication; gastroesophageal reflux disease; hernia hiatal; laparoscopy

Funding

  1. Wu Jieping Medical Foundation Clinical Research Special Supporting Fund [320.6750.2020-16-1]

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This retrospective study evaluated the effectiveness of a biological mesh in the 4K laparoscopic repair of hiatal hernia. The results showed that the tension-free repair with a biological mesh effectively relieved GERD symptoms and no recurrence occurred during the follow-up period, but some patients experienced dysphagia.
Laparoscopic Nissen fundoplication and esophagoplasty are the standards for gastroesophageal reflux disease (GERD) and hiatal hernia (HH) repair. Biologically derived mesh is also associated with reduced recurrence. This study attempted to evaluate the effectiveness of a biological mesh in the 4K laparoscopic repair of HH. This retrospective study reviewed patients with a severe GERD complicated with HH from August 2019 to August 2020. All patients underwent the HH repair using a biological mesh under a 4K laparoscope accompanying Nissen fundoplication. Up to 16 months postoperatively, GERD-health-related quality-of-life (GERD-HRQL) scale, radiologic studies on HH recurrence, and symptoms were recorded. The mean surgical time and postoperative hospital stay were 70.9 +/- 8.72min, 4.8 +/- 0.76 days, respectively. The postoperative symptom relief rate was 96.5%, and no recurrence exhibited during follow-up. Dysphagia occurred in 10 (9.43%) patients. There were no intraoperative vagus nerve injury or postoperative complications, mesh infection, and reoperation for mesh. The tension-free repair of HH with the biological mesh is an option for clinical use, with effectiveness and few short-term complications being reported.

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