The use of mesh implants in laparoscopic treatment of large hiatal hernias
DOI:
https://doi.org/10.11603/2414-4533.2020.3.11123Keywords:
hiatal hernia, mesh implants, cruroraphyAbstract
The aim of the work: to study the effectiveness of using various types of mesh implants in the treatment of patients with large hiatal hernia.
Materials and Methods. From January 2011 to September 2018, 187 patients with large hiatal hernias were operated in our clinic. The average age of patients was (57±14.9) (39 to 78 years). The average body mass index in the operated patients was (28.6±5.4) kg. All patients, depending on the method of hiatal hernia repair, were divided into 4 groups. In group I (54 patients), simple cruroraphy was performed. In group II (59 patients), a self-fixating ProGrip mesh was used to reinforcement the crural repair. In group III (49 patients), a Parietex mesh implant with a collagen coating was used. In group IV (25 patients), an absorbable Vicryl mesh implant was used. Long-term results were studied for 6, 12, 24, 36, 48, and 60 months after surgery. Patients underwent barium swallow study, upper endoscopy and 24-hour pH-metry with the calculation of the index DeMeester. All complaints were recorded in patients, the quality of life was determined according to the GERD-HRQL questionnaire.
Results and Discussion. All surgical interventions were performed laparoscopically without conversion to open surgery. In 10 patients, intraoperative complications were observed. In the long-term follow-up from 24 to 60 months, 74.87 % of the operated patients were examined. The number of recurrences after 60 months in the group with simple crurography was 26.3 %, which was significantly higher than in the groups where non-absorbable mesh ProGrip and Parietex implants were used (4.5 and 7.9 %, respectively). The group of patients with using absorbable Vicryl mesh showed worse results compared to the groups where non-absorbable meshes were used, the recurrence rate in this group was 20 %. After 48 months of follow-up, the Quality of Life Index was significantly higher in patients who used mesh implants. The DeMeester index in the group I of patients was 18.8 and was higher than in the groups of patients with mesh repair.
References
Grubnik, V.V., & Malinovskiy, A.V. (2015). Kriticheskie aspekty laparoskopicheskoy hirurgii gastroezofagealnoy reflyuksnoy bolezni i gryzh pishchevodnogo otverstiya diafragmy [Critical aspects of laparoscopic surgery of gastroesophageal reflux disease and hiatal hernia]. Odesa: VMV–tipografiya [in Russian].
Stefanidis, D., Hope, W. W., Kohn, G. P., Reardon, P. R., Richardson, W. S., Fanelli, R. D., & SAGES Guidelines Committee (2010). Guidelines for surgical treatment of gastroesophageal reflux disease. Surgical Endoscopy, 24(11), 2647-2669. Retrieved from: https://doi.org/10.1007/s00464-010-1267-8. DOI: https://doi.org/10.1007/s00464-010-1267-8
Kohn, G.P., Price, R.R., DeMeester, S.R., Zehetner, J., Muensterer, O.J., Awad, Z., Mittal, S.K., Richardson, W.S., Stefanidis, D., Fanelli, R.D., & SAGES Guidelines Committee (2013). Guidelines for the management of hiatal hernia. Surgical Endoscopy, 27(12), 4409-4428. Retrieved from: https://doi.org/10.1007/s00464-013-3173-3. DOI: https://doi.org/10.1007/s00464-013-3173-3
Frantzides, C.T., Carlson, M.A., Loizides, S., Papafili, A., Luu, M., Roberts, J., Zeni, T., & Frantzides, A. (2010). Hiatal hernia repair with mesh: a survey of SAGES members. Surgical Endoscopy, 24 (5), 1017-1024. Retrieved from: https://doi.org/10.1007/s00464-009-0718-6. DOI: https://doi.org/10.1007/s00464-009-0718-6
Huddy, J.R., Markar, S.R., Ni, M.Z., Morino, M., Targarona, E.M., Zaninotto, G., & Hanna, G.B. (2016). Laparoscopic repair of hiatus hernia: Does mesh type influence outcome? A meta-analysis and European survey study. Surgical Endoscopy, 30(12), 5209-5221. Retrieved from: https://doi.org/10.1007/s00464-016-4900-3 DOI: https://doi.org/10.1007/s00464-016-4900-3
Rathore, M.A., Andrabi, S.I., Bhatti, M.I., Najfi, S.M., & McMurray, A. (2007). Metaanalysis of recurrence after laparoscopic repair of paraesophageal hernia. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 11(4), 456-460.
Stadlhuber, R.J., Sherif, A.E., Mittal, S.K., Fitzgibbons, R.J., Jr, Michael Brunt, L., Hunter, J.G., Demeester, T.R., Swanstrom, L.L., Daniel Smith, C., & Filipi, C.J. (2009). Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series. Surgical Endoscopy, 23 (6), 1219-1226. Retrieved from: https://doi.org/10.1007/s00464-008-0205-5. DOI: https://doi.org/10.1007/s00464-008-0205-5
Tatum, R.P., Shalhub, S., Oelschlager, B.K., & Pellegrini, C.A. (2008). Complications of PTFE mesh at the diaphragmatic hiatus. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract, 12 (5), 953-957. Retrieved from: https://doi.org/10.1007/s11605-007-0316-7. DOI: https://doi.org/10.1007/s11605-007-0316-7
Granderath, F.A., Schweiger, U.M., & Pointner, R. (2007). Laparoscopic antireflux surgery: tailoring the hiatal closure to the size of hiatal surface area. Surgical Endoscopy, 21 (4), 542-548. Retrieved from: https://doi.org/10.1007/s00464-006-9041-7. DOI: https://doi.org/10.1007/s00464-006-9041-7
Falk, G.L. (2016). Giant paraesophageal hernia repair and fundoplication: A timely discussion. Journal of the American College of Surgeons, 222 (3), 329-330. Retrieved from: https://doi.org/10.1016/j.jamcollsurg.2015.11.032. DOI: https://doi.org/10.1016/j.jamcollsurg.2015.11.032
Grubnik, V.V., & Malynovskyy, A.V. (2013). Laparoscopic repair of hiatal hernias: new classification supported by long-term results. Surgical Endoscopy, 27 (11), 4337-4346. Retrieved from: https://doi.org/10.1007/s00464-013-3069-2. DOI: https://doi.org/10.1007/s00464-013-3069-2
Oor, J.E., Roks, D.J., Koetje, J.H., Broeders, J.A., van Westreenen, H.L., Nieuwenhuijs, V.B., & Hazebroek, E.J. (2018). Randomized clinical trial comparing laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh. Surgical Endoscopy, 32 (11), 4579-4589. Retrieved from: https://doi.org/10.1007/s00464-018-6211-3. DOI: https://doi.org/10.1007/s00464-018-6211-3
Ilyashenko, V.V., Grubnyk, V.V., & Grubnik, V.V. (2018). Laparoscopic management of large hiatal hernia: mesh method with the use of ProGrip mesh versus standard crural repair. Surgical Endoscopy, 32 (8), 3592-3598. Retrieved from: https://doi.org/10.1007/s00464-018-6087-2. DOI: https://doi.org/10.1007/s00464-018-6087-2
Zhang, C., Liu, D., Li, F., Watson, D.I., Gao, X., Koetje, J.H., Luo, T., Yan, C., Du, X., & Wang, Z. (2017). Systematic review and meta-analysis of laparoscopic mesh versus suture repair of hiatus hernia: objective and subjective outcomes. Surgical Endoscopy, 31 (12), 4913-4922. Retrieved from: https://doi.org/10.1007/s00464-017-5586-x. DOI: https://doi.org/10.1007/s00464-017-5586-x
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
