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Surgical Endoscopy

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01-11-2013 | Review

Mesh in laparoscopic large hiatal hernia repair: a systematic review of the literature

Authors: Edgar Furnée, Eric Hazebroek

Published in: Surgical Endoscopy | Issue 11/2013

Abstract

Background

The use of mesh is becoming more popular for large hiatal hernia (type II–IV) repair to reduce the recurrence rate. The aim of this study was to outline the currently available literature on the use of mesh in laparoscopic large hiatal hernia repair, emphasizing objective outcome.

Methods

A structured search of the literature was performed in the Medline, Embase, and Cochrane Central Register of Controlled Trials databases.

Results

A total of 26 studies met the inclusion criteria. There were three randomized controlled trials, seven prospective and five retrospective cohort studies, and five prospective and one retrospective case–control study. The study design was not reported in the remaining studies. In the included studies, laparoscopic hiatal hernia repair was performed with mesh in 924 patients (mesh group) and without mesh in 340 patients (nonmesh group). The type of mesh used was very different: polypropylene in six, biomesh in nine, polytetrafluoroethylene (PTFE) in two, expanded PTFE (ePTFE) in two, and composite polypropylene–PTFE in another two. At least two different kinds of mesh were used in five studies. Radiological and/or endoscopic follow-up was performed after a mean (±SEM) period of 25.2 ± 4.0 months. There was no or only a small recurrence (recurrent hiatal hernia <2 cm) in 385 of the 451 available patients (85.4 %) in the mesh group and in 182 of 247 (73.7 %) in the nonmesh group.

Conclusions

The use of mesh in the repair of large hiatal hernias is promising with respect to the reduction of anatomical recurrences. However, many different kinds and configurations of mesh are available. This systematic review of the literature is a basis for high-quality randomized controlled trials to obtain the most effective and safe mesh in the long term.

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Title: Mesh in laparoscopic large hiatal hernia repair: a systematic review of the literature
Authors: Edgar Furnée
Eric Hazebroek
Publication date: 01-11-2013
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-013-3036-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Mesh in laparoscopic large hiatal hernia repair: a systematic review of the literature

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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