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ISSN 1665-2576 (Print)

2017, Number 2

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Rev Mex Cir Endoscop 2017; 18 (2)

Experience over a decade on giant or recurrent hiatal hernia prosthetic repair

Weber-Sánchez LA, Garteiz-Martínez DE, Carbó-Romano R, Bravo-Torreblanca C, Mateos-López AS

Language: Spanish
References: 31
Page: 66-72
PDF size: 258.44 Kb.


ABSTRACT

Introduction: The use of mesh has been proposed in fundoplication for giant or recurrent hiatal hernia, including closure of the crus. These reports do not focus on the placement technique, something we believe is important. Our goal is to analyze those results when placing a circumferential polypropylene coated with oxidized cellulose in cases of giant or recurrent hiatal hernia. Material and methods: This is a retrospective and descriptive study on patients submitted to a Nissen laparoscopic fundoplication for giant or recurrent hiatal hernia including mesh placement from March 2005 to May 2017. In all cases, crus closure, Nissen fundoplication and circumferential mesh placement over the repaired hiatus were performed. Technique, surgical time, hospital stay, conversion, complications and follow-up were analyzed. In terms of patients satisfaction and recurrence of reflux symptoms. Results: 36 patients were analyzed, 15 with primary and 21 with a previous fundoplication. 21 female and 15 male patients with age between 35 to 71 years. Surgical time and hospital stay was higher in patients with a previous procedure. No conversions or complications were reported. All patients except one were satisfied with the surgical procedure as a result of SF 36 questionnaire. Conclusions: The use of mesh is still a matter of debate but it is a useful resource in order to prevent recurrence. Tailoring of the mesh to be placed circumferentially to the esophagus in this series, didn’t cause complications such as dysphagia or erosions and it seems to be an effective technique in terms of patients satisfaction.


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