Long-term outcomes of radiologic recurrence after paraesophageal hernia repair with mesh

Abstract

In this study, PEH repair with mesh was safe and effective at controlling symptoms over the long term. Radiologic recurrence rate increased over time and was highest in patients with hernias >5 cm. Therefore, in our experience, PEH repair with mesh is a safe therapy and though radiologic recurrence does increase with time, symptom resolution is maintained.

Paraesophageal hernia repair in the emergency setting: is laparoscopy with the addition of a fundoplication the new gold standard?

“…At 12 months, patients showed significant improvement in their symptoms with reduction in heartburn by 77.5 % (p \ 0.05), decreased regurgitation by 74.4 % (p \ 0.05), and belching had subsided by 60.6 % (p \ 0.05). These symptoms continued to show statistically significant improvement at 5-year follow-up as well [10]. These results are further supported by our analysis, which also shows decreased morbidity and mortality in the laparoscopic cases, illustrating that laparoscopic PEH repair can be both safe and effective.…”

“…In addition, the median morbidity rate was 4.3 % in the laparoscopic group, as opposed to 16.2 % in the conventional group [9]. Jones et al [10] performed a retrospective analysis on 209 patients who underwent laparoscopic PEH repair at one institution between December 2004 and March 2013. All cases included an absorbable mesh to reinforce the cruroplasty and a complete or partial wrap depending on routine preoperative workup with esophageal manometry.…”

Thinking About Hiatal Hernia Recurrence After Laparoscopic Repair: When Should It Be Considered a True Recurrence? A Different Point of View

“…The Nebraska group presented a follow-up of 209 patients in which they demonstrated high recurrence rates that increased over time from 16% at 1 year up to 40% after 5 years. 4 The recurrence rate was higher for hernias larger than 5 cm (23% versus 16%), reaching 40% in patients with a new fundoplication for reherniation after surgery. These results are similar to the results published by Oeschlager et al 2,12 in their multicenter trial.…”

“…Oeschlager et al 12 also concludes that despite frequent radiologic recurrence, symptoms are well tolerated, patient satisfaction is very high, and reoperation rates are very low. In the study of the group of Jones et al, 4 preoperative symptoms improved in 70% of patients, despite the presence of a recurrent hiatal hernia.…”

“…[1][2][3][4][5][6] A critical analysis of the reported results at 1 year has shown less recurrence after a mesh repair, but this issue is still controversial because of the great variability in technique, type of mesh, and size and shape of the hernia. [4][5][6][7][8][9] A higher rate of recurrence has been reported after laparoscopic repair, especially in giant hiatal hernias. The use of mesh can reduce the recurrence rate, and other authors have suggested performing the Collis Nissen procedure in patients with a hiatal hernia and short esophagus, reporting lower recurrence rates after this procedure.…”