Mesh placement for hiatal hernia repair

Hiatal hernia is a common disorder characterized by the protrusion of abdominal structures other than esophagus in thoracic cavity. Large hiatal hernias, also called paraesophageal hernia (PEH), contain a large part of the stomach, including other organs, into the mediastinum. The Guidelines of Soci...

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Autores: Balagué Ponz, Carmen|||0000-0003-2429-8297, Fernández-Ananín, Sonia|||0000-0002-5068-1954, Sacoto, D., Targarona, Eduardo M.|||0000-0001-7557-6934
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:270183
Acesso em linha:https://ddd.uab.cat/record/270183
https://dx.doi.org/urn:doi:10.21037/ls-20-89
Access Level:acceso abierto
Palavra-chave:Hiatal hernia
Biological mesh (BM)
Nonabsorbable mesh
Polytetrafluoroethylene (PTFE)
Polypropylene (PP)
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spelling Mesh placement for hiatal hernia repairCan we solve the controversy?Balagué Ponz, Carmen|||0000-0003-2429-8297Fernández-Ananín, Sonia|||0000-0002-5068-1954Sacoto, D.Targarona, Eduardo M.|||0000-0001-7557-6934Hiatal herniaBiological mesh (BM)Nonabsorbable meshPolytetrafluoroethylene (PTFE)Polypropylene (PP)Hiatal hernia is a common disorder characterized by the protrusion of abdominal structures other than esophagus in thoracic cavity. Large hiatal hernias, also called paraesophageal hernia (PEH), contain a large part of the stomach, including other organs, into the mediastinum. The Guidelines of Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommends that patients' age and comorbidities must be considered before to decide the routine elective repair of asymptomatic PEH. Nevertheless, truly asymptomatic PEH are rare and post-prandial chest fullness or shortness of breath are often the symptoms present instead of heartburn and reflux. The complete reduction of the mediastinal sac with a wide esophageal mobilization and a tension-free hiatal closure are necessary for a correct PEH repair. However, a tension-free cruroplasty is not easy, with a recurrence rate of up to 42%. The introduction of synthetic mesh (SM) reinforcement, could ameliorate the results and several studies have reported lower recurrence rates with its use. However, also severe complications have been reported and biological meshes (BMs) have been proposed as an alternative although with conflicting results regarding efficacy. On the other hand, several studies describe better clinical results on long term follow-up than expected even with a high radiological recurrence rate. 22021-01-0120212021-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/270183https://dx.doi.org/urn:doi:10.21037/ls-20-89reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2701832026-06-06T12:50:31Z
dc.title.none.fl_str_mv Mesh placement for hiatal hernia repair
Can we solve the controversy?
title Mesh placement for hiatal hernia repair
spellingShingle Mesh placement for hiatal hernia repair
Balagué Ponz, Carmen|||0000-0003-2429-8297
Hiatal hernia
Biological mesh (BM)
Nonabsorbable mesh
Polytetrafluoroethylene (PTFE)
Polypropylene (PP)
title_short Mesh placement for hiatal hernia repair
title_full Mesh placement for hiatal hernia repair
title_fullStr Mesh placement for hiatal hernia repair
title_full_unstemmed Mesh placement for hiatal hernia repair
title_sort Mesh placement for hiatal hernia repair
dc.creator.none.fl_str_mv Balagué Ponz, Carmen|||0000-0003-2429-8297
Fernández-Ananín, Sonia|||0000-0002-5068-1954
Sacoto, D.
Targarona, Eduardo M.|||0000-0001-7557-6934
author Balagué Ponz, Carmen|||0000-0003-2429-8297
author_facet Balagué Ponz, Carmen|||0000-0003-2429-8297
Fernández-Ananín, Sonia|||0000-0002-5068-1954
Sacoto, D.
Targarona, Eduardo M.|||0000-0001-7557-6934
author_role author
author2 Fernández-Ananín, Sonia|||0000-0002-5068-1954
Sacoto, D.
Targarona, Eduardo M.|||0000-0001-7557-6934
author2_role author
author
author
dc.subject.none.fl_str_mv Hiatal hernia
Biological mesh (BM)
Nonabsorbable mesh
Polytetrafluoroethylene (PTFE)
Polypropylene (PP)
topic Hiatal hernia
Biological mesh (BM)
Nonabsorbable mesh
Polytetrafluoroethylene (PTFE)
Polypropylene (PP)
description Hiatal hernia is a common disorder characterized by the protrusion of abdominal structures other than esophagus in thoracic cavity. Large hiatal hernias, also called paraesophageal hernia (PEH), contain a large part of the stomach, including other organs, into the mediastinum. The Guidelines of Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommends that patients' age and comorbidities must be considered before to decide the routine elective repair of asymptomatic PEH. Nevertheless, truly asymptomatic PEH are rare and post-prandial chest fullness or shortness of breath are often the symptoms present instead of heartburn and reflux. The complete reduction of the mediastinal sac with a wide esophageal mobilization and a tension-free hiatal closure are necessary for a correct PEH repair. However, a tension-free cruroplasty is not easy, with a recurrence rate of up to 42%. The introduction of synthetic mesh (SM) reinforcement, could ameliorate the results and several studies have reported lower recurrence rates with its use. However, also severe complications have been reported and biological meshes (BMs) have been proposed as an alternative although with conflicting results regarding efficacy. On the other hand, several studies describe better clinical results on long term follow-up than expected even with a high radiological recurrence rate.
publishDate 2021
dc.date.none.fl_str_mv 2
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
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https://dx.doi.org/urn:doi:10.21037/ls-20-89
url https://ddd.uab.cat/record/270183
https://dx.doi.org/urn:doi:10.21037/ls-20-89
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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