Biologic Prosthesis to Prevent Recurrence after Laparoscopic Paraesophageal Hernia Repair: Long-term Follow-up from a Multicenter, Prospective, Randomized Trial

Oelschlager, Brant K.; Pellegrini, Carlos A.; Hunter, John G.; Brunt, Michael; Soper, Nathaniel J.; Sheppard, Brett C.; Polissar, Nayak L.; Neradilek, Moni B.; Mitsumori, Lee M.; Rohrmann, Charles A.; Swanstrom, Lee L.

doi:10.1016/j.jamcollsurg.2011.05.017

Cited by 398 publications

(294 citation statements)

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“…In our randomized trial we compared 3 different approaches to repair, including sutures vs. synthetic vs. biological mesh. We recently reported no significant differences for hernia recurrence or clinical outcomes for the 3 repair methods in the trial 15 , and these results were similar to the late follow-up outcomes reported previously by Oelschlager et al 14 . In both our trial and…”

Section: Discussionsupporting

confidence: 90%

“…Apart from the "Role Functioning-Emotional" subscale at 24 months follow-up, there was a significant improvement in all subscales of the SF-36 questionnaire, the two composite scales and the Reported Health Transition at three, six, 12, and 24 months postoperatively, when compared to the pre-operative scores. This confirms the effectiveness of laparoscopic repair of large hiatal hernias, and supports other studies that have shown good clinical and objective outcomes following this surgery 14,15 .…”

Section: Discussionsupporting

confidence: 89%

“…Our decision to use a posterior mesh reinforcement technique was based on encouraging early trial outcomes from both Oelschlager et al 14 and Granderath et al 23 , as well as concern that encircling the esophagus with mesh might increase the risk of mesh erosion 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports from randomized trials 13,14,15,23 , and other studies 4,6,10 have all focussed on clinical and objective outcome parameters. However, quality of life is an alternative patient reported outcome, which reflects the general well-being and the functional status of patients.…”

Section: Discussionmentioning

confidence: 99%

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Quality of Life Following Repair of Large Hiatal Hernia is Improved but not Influenced by Use of Mesh: Results From a Randomized Controlled Trial

et al. 2015

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Introduction Laparoscopic surgery is the treatment of choice for repair of large hiatus hernia, but can be followed by recurrence. Repair with prosthetic mesh has been recommended to prevent recurrence, although complications following mesh repair have generated disagreement about whether or not mesh should be used. The early objective and clinical results of a randomized trial of repair with mesh versus sutures have been reported, and revealed few differences. In the current study, we evaluated quality of life outcomes within this trial at follow-up to 2 years. Methods In a multicenter prospective double-blind randomized trial three methods for repair of large hiatus hernia were compared: sutures versus repair with absorbable mesh (Surgisis) versus non-absorbable (Timesh). Quality of life assessment using the Short-Form 36 (SF-36) questionnaire was undertaken at 3, 6, 12 and 24 months after surgery. SF-36 outcomes (8 individual scales and 2 composite scales) were determined for each group, and compared between groups, and across different follow-up points. Results 126 patients were enrolled-43 sutures, 41 absorbable mesh and 42 non-absorbable mesh. 115 (91.3 %) completed a preoperative questionnaire, and 113 (89.7 %) completed the post-operative questionnaire at 3 months, 116 (92.1 %) at 6 months, 114 (90.5 %) at 12 months, and 91 (72.2 %) at 24 months. The SF-36 Physical and Mental Component Scores (PCS and MCS) improved significantly following surgery, and this improvement was sustained across 24 months follow-up (p \ 0.001 for PCS and MCS at each follow-up point). There were no significant differences between the groups for the component scores or the eight SF-36 subscale scores at each follow-up time. 29 individuals had a recurrence at 6 months follow-up, of which 9 were symptomatic. The PCS were higher in patients with recurrence versus without (p \ 0.01), and in patients with a symptomatic recurrence versus asymptomatic recurrence versus no recurrence (p = 0.001). Conclusion SF-36 measured quality of life improved significantly after repair of large hiatal hernia at up to 2 years follow-up, and there were no differences in outcome for the different repair techniques. The use of mesh versus no mesh in repair of large hiatal hernia did not influence quality of life.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Quality of Life Following Repair of Large Hiatal Hernia is Improved but not Influenced by Use of Mesh: Results From a Randomized Controlled Trial

et al. 2015

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“…However, it is still a kind of difficult surgery in the field of hernia surgery that requires a good understanding of the surrounding anatomy of the gastroesophageal junction and esophageal hiatus as well as precise operation (3). Sufficient dissection and exposure of the operating field, application of mesh and fundoplication are some key issues in these operations (4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%