Dysphagia caused by migrated mesh after paraesophageal hernia repair

Arroyo, Quetzalihuitl; Argüelles-Arias, Federico; Jimenez-Saenz, Manuel; Herrerias-Gutierrez, J. M.; Bautista, F. Pellicer

doi:10.1055/s-0030-1256520

Cited by 11 publications

(5 citation statements)

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“…Two prospective, randomized clinical trials have shown that "tension-free" laparoscopic hernia repair with prosthetic graft prevents recurrence [5,6]. However, use of synthetic materials for crural reinforcement produced potentially serious problems, such as erosion and dysphagia [6][7][8][9]. This leads to popularization of biological grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown higher recurrence rates after a suture-based repair of hiatal hernias [2][3][4]. A "tension-free" repair with prosthetic mesh allowed decreasing recurrence [5], but the use of synthetic materials produced potentially serious problems, such as erosion and dysphagia [6][7][8][9]. Multiple reports showed reduction in short-term recurrence rate after hiatal hernia repair with biologic grafts [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Different Biologic Grafts for Diaphragmatic Crura Reinforcement During Laparoscopic Repair of Large Hiatal Hernia: A Six-Year Single Surgeon Experience

Reznichenko

2016

J Curr Surg

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Background: Large hiatal hernias represent a challenge for surgeons. Biologic grafts are currently popular for the strengthening of crural closure during laparoscopic repair. This study is a retrospective review of crural reinforcement in laparoscopic repair of large hiatal hernias using various biologic grafts performed by a single surgeon in a rural community hospital. Methods: Eleven (n = 11) patients underwent laparoscopic repair of large hiatal hernia in a rural community hospital by a single surgeon from 2009 to 2015. Standard laparoscopic hiatal hernia repair was performed. Different biologic grafts were used for crural reinforcement, including "AlloMax", "Permacol", and "Acell MatriStem". Perioperative data and outcomes of surgery were evaluated. Results: There were six females and five males, with a mean age of 55.4 years and a mean body mass index of 32.5. Eight patients had type III hiatal hernia, two patients had type IV, and one patient had type II. Mean operative time was 244.6 minutes, and mean length of stay was 3.3 days. Mean size of herniated stomach in the chest was 62%. Mean size of the hiatal defect was 7.7 × 6.4 cm. One perioperative complication (9%) included bleeding from left gastric artery. Early complications included shortness of breath (18%), parapneumonic effusion (18%), and early dysphagia (18%). Late complications included persistent gastroesophageal reflux (9%), gastroparesis (9%), and persistent dysphagia (9%). Radiological recurrence was 18% and clinical recurrence was 9% at mean follow-up of 15 months. Conclusions: Laparoscopic repair of large hiatal hernia could be safely performed in rural community hospitals. The choice of the biologic graft, if one is used, should be at the discretion of the surgeon. The cost and availability of the biologic graft are important in decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Different Biologic Grafts for Diaphragmatic Crura Reinforcement During Laparoscopic Repair of Large Hiatal Hernia: A Six-Year Single Surgeon Experience

Reznichenko

2016

J Curr Surg

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“…Closure with mesh typically is reserved for situations where the defect is too large to be closed primarily. Concerns regarding the routine use of mesh include the potential for mesh erosion into the stomach or esophagus, esophageal stricture formation, mesh migration, and infection [16, 17]. Most surgeons have abandoned the use of nonabsorbable mesh at the esophageal hiatus for these reasons [15].…”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Traumatic Right-Sided Diaphragmatic Hernia after Abdominoplasty

Jadlowiec

Sakorafas

2014

Case Reports in Surgery

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Traumatic diaphragmatic hernias are rare and challenging to diagnose. Following trauma, diagnosis may occur immediately or in a delayed fashion. It is believed that left traumatic diaphragmatic hernias are more common as a result of the protective right-sided anatomic lie of the liver. If unrecognized, traumatic diaphragmatic injuries are subject to enlarge over time as a result of the normal pressure changes observed between the thoracic and abdominal cavities. Additionally, abrupt changes to the pressure gradients, such as those which occur with positive pressure ventilation or surgical manipulation of the abdominal wall, can act as a nidus for making an asymptomatic hernia symptomatic. We report our experience with a delayed traumatic right-sided diaphragmatic hernia presenting with large bowel incarceration two months after abdominoplasty. In our review of the literature, we were unable to find any reports of delayed presentation of a traumatic right-sided diaphragmatic hernia occurring acutely following abdominoplasty.

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“…There were no graft related complications, such as erosion and stricture formation as can be seen with permanent prosthetic meshes. [16][17][18][19] Mesh-related complications is vexing in both biologically derived grafts and prosthetic mesh repairs. Having a graft that is safe to use around the relatively mobile esophagus is comforting.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic, Radiological, and Quality of Life Outcome of Paraesophageal Hernia Repair With Urinary Bladder Extracellular Surgical Matrix: Comparison With Primary Repair

Wang¹,

Tran²,

Montera³

et al. 2019

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction: Paraesophageal hernia repairs are prone to recurrence and mesh reinforcement is common. Both biologic and prosthetic meshes have been used. We report a comparison of a new type of biologically derived graft, Gentrix Surgical Urinary Bladder Matrix (UBM). Methods:The medical records of 65 patients who underwent paraesophageal hernia repair (PEHR) were reviewed. Primary data points included demographics, first-time or recurrent hernia, operative approach, graft or primary repair, operative time, and postoperative complications. Patients then underwent upper gastrointestinal series, completed the GERD-HRQL symptom severity questionnaire, and the SF-36 generic quality of life instrument.Results: A total of 32 patients underwent graft-reinforced repair, 33 underwent primary repair. More patients in the UBM group were being treated for recurrent PEH. Demographic data and postoperative complications were similar. There was no difference in recurrence rates, size of recurrence, postoperative symptomatic or quality of life improvement. Patients who suffered recurrence in the primary repair group had more severe symptoms and a higher rate of dissatisfaction. Of the 3 patients with recurrences after Gentrix placement, reoperation demonstrated anterior failure where no reinforcement had occurred because of the posteriorly placed U-shaped graft.Conclusions: The use of UBM was not associated with an increased complications despite use in more difficult patients. Although there appeared to be no difference in recurrence rate or size, it was associated with less severe symptomatic recurrences. The U-shape configuration is prone to recurrence at the site of the repair not covered by the graft, suggesting that a keyhole configuration may be superior.

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Dysphagia caused by migrated mesh after paraesophageal hernia repair

Abstract: UCTN-Unusual cases and technical notes E257 Arroyo Q et al. Dysphagia caused by migrated mesh after paraesophageal hernia repair … Endoscopy 2011; 43: E257-E258 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 11 publications

References 0 publications

Different Biologic Grafts for Diaphragmatic Crura Reinforcement During Laparoscopic Repair of Large Hiatal Hernia: A Six-Year Single Surgeon Experience

Different Biologic Grafts for Diaphragmatic Crura Reinforcement During Laparoscopic Repair of Large Hiatal Hernia: A Six-Year Single Surgeon Experience

Delayed Presentation of Traumatic Right-Sided Diaphragmatic Hernia after Abdominoplasty

Symptomatic, Radiological, and Quality of Life Outcome of Paraesophageal Hernia Repair With Urinary Bladder Extracellular Surgical Matrix: Comparison With Primary Repair

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