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Surgical Endoscopy
Published in: Surgical Endoscopy 5/2010

01-05-2010

Hiatal hernia repair with mesh: a survey of SAGES members

Authors: Constantine T. Frantzides, Mark A. Carlson, Sofronis Loizides, Anastasia Papafili, Mihn Luu, Jacob Roberts, Tallal Zeni, Alexander Frantzides

Published in: Surgical Endoscopy | Issue 5/2010

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Abstract

Background

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 problem.

Methods

A questionnaire on the technique and results of mesh hiatal herniorrhaphy was sent to 1,192 members of the Society of Gastrointestinal and Endoscopic Surgeons (SAGES).

Results

There were 275 responses; 261 of these were analyzed. A total of 5,486 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 0.2%, and an erosion rate of 0.3%. Biomaterial tended to be associated with failure, whereas nonabsorbable mesh tended to be associated with stricture and erosion.

Conclusions

The use of mesh during hiatal hernia repair resulted in a reported recurrence rate which appeared to be lower than that obtained historically without mesh. No one mesh type was clearly superior in terms of avoiding failure and complication.
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Metadata
Title
Hiatal hernia repair with mesh: a survey of SAGES members
Authors
Constantine T. Frantzides
Mark A. Carlson
Sofronis Loizides
Anastasia Papafili
Mihn Luu
Jacob Roberts
Tallal Zeni
Alexander Frantzides
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 5/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-009-0718-6

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