Risk factors associated with radiological and clinical recurrences after laparoscopic repair of large hiatal hernia with TiO 2 Mesh™ reinforcement.

Autor: Priego P; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain., Juez LD; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain. luz.juez@gmail.com., Cuadrado M; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain., García Pérez JC; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Surgery, Universidad de Alcalá, Madrid, Spain., Sánchez-Picot S; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain., Blázquez LA; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Surgery, Universidad de Alcalá, Madrid, Spain., Gil P; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Surgery, Universidad de Alcalá, Madrid, Spain., Galindo J; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Surgery, Universidad de Alcalá, Madrid, Spain., Fernández-Cebrián JM; Division of Esophagogastric and Bariatric Surgery, Department of General and Digestive Surgery, Facultad de Medicina, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.; Department of Surgery, Universidad de Alcalá, Madrid, Spain.
Jazyk: angličtina
Zdroj: Hernia : the journal of hernias and abdominal wall surgery [Hernia] 2024 Oct; Vol. 28 (5), pp. 1871-1877. Date of Electronic Publication: 2024 Jul 13.
DOI: 10.1007/s10029-024-03107-8
Abstrakt: Introduction: Laparoscopic repair of large para-esophageal hiatal hernias (LPHH) remains controversial. Several meta-analyses suggest hiatus reinforcement with mesh has better outcomes over cruroplasty in terms of less recurrence. The aim of this study was to evaluate the medium-term results of treating LPHH with a biosynthetic monofilament polypropylene mesh coated with titanium dioxide to enhance biocompatibility (TiO 2 Mesh™).
Methods: A retrospective observational study, using data extracted from a prospectively collected database was performed at XXX from December 2014 to June 2023. Included participants were all patients who underwent laparoscopic repair of large (> 5 cm) type III hiatal hernia in which a TiO 2 Mesh™ was used. The results of the study, including clinical and radiological recurrences as well as mesh-related morbidity, were analyzed.
Results: Sixty-seven patients were finally analyzed. Laparoscopic approach was attempted in all but conversion was needed in one patient because of bleeding in the lesser curvature. With a median follow-up of 41 months (and 10 losses to follow-up), 22% of radiological recurrences and 19.3% of clinical recurrences were described. Regarding complications, one patient presented morbidity associated with the mesh (mesh erosion requiring endoscopic extraction). Recurrent hernia repair was an independent factor of clinical recurrence (OR 4.57 95% CI (1.28-16.31)).
Conclusion: LPHH with TiO 2 Mesh™ is safe and feasible with a satisfactory medium-term recurrence and a low complication rate. Prospective randomized studies are needed to establish the standard repair of LPHH.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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