Randomized clinical trial comparing laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh
Randomized clinical trial comparing laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh
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DOI：
10.1007/s00464-018-6211-3
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发表时间：
2018-11-01
影响因子：
3.1
通讯作者：
Hazebroek, Eric J.
中科院分区：
文献类型：
--
作者：
Oor, Jelmer E.;Roks, David J.;Hazebroek, Eric J.
BackgroundCurrent literature is characterized by a discrepancy between reported symptomatic and radiological recurrent hiatal hernia's following primary repair. Crural augmentation using mesh is suggested to reduce recurrence rates. The aim of this trial is to analyze 1-year outcome of laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh.MethodsBetween 2013 and 2016, 72 patients with an objectified hiatal hernia were randomized for primary repair using non-absorbable sutures and sutures reinforced with non-absorbable mesh. Data regarding the incidence of recurrent hiatal hernia, need for endoscopic dilatation or surgical reintervention, postoperative dysphagia and/or reflux symptoms, general health, and use of acid-suppressing medication were analyzed.Results72 patients (n=36 vs. n=36) were included. One year after primary repair and repair using non-absorbable mesh, there were no differences in the number of recurrent hiatal hernia's demonstrated by barium swallow radiology (n=4 [11.4%] vs. n=6 [19.4%], p=0.370) or upper gastrointestinal endoscopy (n=5 [14.4%] vs. n=5 [17.2%], p=0.746), the number of surgical reinterventions (n=2 [5.6%] vs. n=1 [2.8%], p=1.000), nor in chest pain and heartburn scores, with comparable dysphagia and satisfaction scores. Compared to the preoperative state, both groups demonstrated a comparable and significant reduction in chest pain score and Dakkak dysphagia score.ConclusionsUse of non-absorbable mesh to reinforce primary hiatal hernia repair results in equal hiatal hernia recurrence and symptomatic outcome compared to repair using sutures alone. During 1-year follow-up, there were no mesh-related complications. Follow-up beyond 1year needs to demonstrate whether these findings are sustained.
