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Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence

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Abstract

Purpose

The objective of the present study was to review the pertinent literature and analyze the evidence for and against the use of mesh for hiatal hernia repair, with a focus on the effects on recurrence and postoperative dysphagia.

Methods

A literature search was performed between January 1990 and March 2010. Studies were considered for inclusion, provided (1) they comprised a series of at least 20 patients, (2) they documented a follow-up period of at least 6 months, (3) they reported on the outcome as expressed by hernia recurrence rates, and (4) they reported on type of mesh material, hiatal closure, and antireflux surgery.

Results

Twenty-three articles enrolling a cumulative number of 1,446 patients fulfilled the inclusion criteria. Polypropylene meshes seem to be associated with low recurrence rates (0–22.7%, median 1.9%) and acceptable dysphagia rates (0–21.7%, median 3.9%). Higher dysphagia rates after polytetrafluoroethylene (PTFE) and expanded PTFE (ePTFE) mesh hiatoplasty have been recorded (15.5–34.3%). Even though the use of novel biologic implants for hiatal repair is still in its infancy, the existing results from clinical research are promising.

Conclusions

Polypropylene meshes seem to provide durable results with low dysphagia rates. Unacceptably high recurrence rates for PTFE/ePTFE meshes have been reported. Biologic implant engineering represents a promising field in hiatal hernia surgery.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Certified Reference Center for Minimally Invasive Surgery, Hospital Neuwerk, Mönchengladbach, Germany

    Stavros A. Antoniou & Frank A. Granderath

  2. Department of General Surgery, Hospital Zell am See, Zell am See, Austria

    Stavros A. Antoniou, Oliver O. Koch & Rudolph Pointner

  3. Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK

    George A. Antoniou

  4. Souniou 11, 19001, Keratea Attikis, Athens, Greece

    Stavros A. Antoniou

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  1. Stavros A. Antoniou
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  2. Oliver O. Koch
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  3. George A. Antoniou
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  4. Rudolph Pointner
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  5. Frank A. Granderath
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Correspondence to Stavros A. Antoniou.

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Antoniou, S.A., Koch, O.O., Antoniou, G.A. et al. Mesh-reinforced hiatal hernia repair: a review on the effect on postoperative dysphagia and recurrence. Langenbecks Arch Surg 397, 19–27 (2012). https://doi.org/10.1007/s00423-011-0829-0

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  • DOI: https://doi.org/10.1007/s00423-011-0829-0

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