The Choice of Primary Repair or Mesh Repair for Paraesophageal Hernia

Abstract

Depending on what the decision-maker accepts as the recurrence and reoperation rates for these types of repair, either mesh or primary repair may be the treatment of choice. However, the differences between the two are small, and, perhaps, clinically inconsequential.

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

“…Controversy exists around the reinforcement of the diaphragmatic crura, as well as the type of the graft used, and the value of the graft in preventing recurrence, around short-and long-term complications, and the consequences of those complications compared with primary repair [14].…”

“…At the same time, the quality of life improved significantly after all types of hernia repair [21]. According to the most recent reviews, either mesh repair or primary repair may be the treatment of choice, based on the decision made by individual surgeons, and depending on their own recurrence and reoperation rates [14]. With regard to the choice of mesh, it should also be at the discretion of the surgeon based on his/her experience.…”

“…Biologic grafts used in hiatal hernia repairs are safe, and the incidences of mesh-related complications are low [10,11,[13][14][15][16].…”

Diaphragmatic crural augmentation utilising cross-linked porcine dermal collagen biologic mesh (Permacol™) in the repair of large and complex para-oesophageal herniation: a retrospective cohort study

“…Gibson et al [27] have recently suggested that mesh is not required for a successful outcome and Obeid et al [28] have published a decision-based analysis suggesting the differences between the use of mesh and primary repair are small. However, the majority of studies reviewed, and most existing data published to date, involved patients being randomized to mesh or primary repair with no differentiation in the characteristics of the hernial defect.…”

Laparoscopic Repair of Paraesophageal Hernias with a Falciform Ligament Buttress

“…These complications include gastric and esophageal erosions, strictures of the gastroesophageal junction, and dysphagia. 17 The overwhelming majority of these complications require additional surgeries. In extreme cases, an esophagectomy may be required.…”