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Laparoscopic Paraesophageal Hernia Repair: Utilization Rates of Mesh in the USA and Short-Term Outcome Analysis

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Many studies have shown that the utilization of mesh for paraesophageal hernia repair (PEHR) does not prevent recurrence. The aims of this study were (a) to assess the utilization of mesh for PEHR in the USA and (b) to compare the perioperative outcomes between PEHR with and without mesh.

Methods

A retrospective population-based analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Adult patients who underwent laparoscopic PEHR with and without implantation of mesh between 2011 and 2014 were included. The yearly utilization of mesh, stratified by surgical approach, was estimated using the Poisson regression. Multivariable logistic regression was used to estimate the effect of mesh on 30-day perioperative outcomes.

Results

A total of 9590 laparoscopic PEHR were included, 5814 (60.6%) without mesh and 3776 (39.4%) with mesh. The yearly rate of PEHR with implantation of mesh did not change significantly during the study period (39.4% mesh utilization in 2011, and 38.2% mesh utilization in 2014, p = 0.37). Patients undergoing PEHR with mesh, as compared to those without mesh, had similar incidence of 30-day postoperative morbidity and mortality.

Conclusion

Even though there is no strong evidence to support its use, utilization rates of mesh for laparoscopic PEHR remained high and stable between 2011 and 2014 in the USA. The use of mesh was not associated with a higher incidence of postoperative complications.

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Acknowledgments

Francisco Schlottmann, MD, Paula Strassle, MSPH, and Marco G. Patti, MD, conceived the study and helped with the literature search and writing of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, University of North Carolina at Chapel Hill, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA

    Francisco Schlottmann, Paula D. Strassle & Marco G. Patti

  2. Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA

    Francisco Schlottmann & Marco G. Patti

  3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Paula D. Strassle

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  1. Francisco Schlottmann
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  2. Paula D. Strassle
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Correspondence to Francisco Schlottmann.

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The authors declare that they have no conflict of interest.

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Schlottmann, F., Strassle, P.D. & Patti, M.G. Laparoscopic Paraesophageal Hernia Repair: Utilization Rates of Mesh in the USA and Short-Term Outcome Analysis. J Gastrointest Surg 21, 1571–1576 (2017). https://doi.org/10.1007/s11605-017-3452-8

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  • DOI: https://doi.org/10.1007/s11605-017-3452-8

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