Authors: Constantine T Frantzides Mark A Carlson Sofronis Loizides Anastasia Papafili Mihn Luu Jacob Roberts Tallal Zeni Alexander Frantzides
Publish Date: 2009/12/08
Volume: 24, Issue: 5, Pages: 1017-1024
Abstract
Primary repair of large hiatal hernia is associated with a high recurrence rate The use of mesh may reduce this recurrence rate The indication for mesh use the type of mesh to use and the placement technique are controversial A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clinical problemThere were 275 responses 261 of these were analyzed A total of 5486 hiatal hernia repairs with mesh were reported 77 and 23 were performed laparoscopically vs open respectively The most common indication for mesh usage was an increased size hiatal defect 46 of respondents The most common mesh types were biomaterial 28 polytetrafluoroethylene 25 and polypropylene 21 Suture anchorage was the most common fixation technique 56 of respondents The findings showed a failure rate of 3 a stricture rate of 02 and an erosion rate of 03 Biomaterial tended to be associated with failure whereas nonabsorbable mesh tended to be associated with stricture and erosionThis study was supported with the resources and facilities of the Omaha VA Medical Center and the Chicago Institute of Minimally Invasive Surgery The authors acknowledge Valerie K Shostrom of the Department of Biostatistics at the University of Nebraska Medical Center for assistance with statistical testing
Keywords: