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Surgical Endoscopy

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01-11-2019 | Esophagography

Mid-term safety profile evaluation of Bio-A absorbable synthetic mesh as cruroplasty reinforcement

Authors: Angelo Iossa, Gianfranco Silecchia

Published in: Surgical Endoscopy | Issue 11/2019

Abstract

Purpose

The aim of the present paper is to report the results of a single institution series of hiatal hernia repair (HHR) with augmented mesh hiatoplasty focusing on safety and efficacy profile of Bio-A absorbable synthetic mesh.

Materials and methods

A retrospective evaluation of prospectively maintained database showed 120 consecutive patients submitted to HHR reinforced with bio-absorbable synthetic mesh. The study populations included two groups: (A) 92 obese patients—reinforced hiatoplasty concurrent with bariatric procedure; (B) 28 non-obese patients—reinforced hiatoplasty concurrent with antireflux surgery. Symptoms assessment was made with GERD-HRQL and Rome III. The X-ray with barium swallow, the CT scan, in selected cases, and the endoscopy were used as recurrence evaluation and as endoscopic complications assessment. Only patients with a mean follow-up of 12 months were included in this study. A Cox hazard was made to evaluate factors affecting the recurrence.

Results

No case of intra-peri and post-operative (mean follow-up of 41 months) complications mesh related were registered. The dysphagia-rate was 8.7% for Group A and 11% for Group B. 74% of Group A and 61% of Group B patients are actually PPIs free with median GERD-HRQL score of 4 (from 16) and 6 (from 23), respectively (difference pre-post-operative < 0.05). Recurrence rate was 5.4% in Group A and 7.1% in Group B. The Cox hazard analysis showed that the use of more than four stitches for cruroplasty represents a negative factor on recurrence (HR = 8; p < 0.05).

Conclusions

This is, in our knowledge, the largest report (120 consecutive patients) with mid-term follow-up (41 months of mean FU) on bio-absorbable mesh on the hiatus in obese and non-obese patients. These results supports the use of absorbable mesh for HHR (safe profile—0% of complications rate), showing excellent recurrence rate results and good GERD symptoms control.

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Title: Mid-term safety profile evaluation of Bio-A absorbable synthetic mesh as cruroplasty reinforcement
Authors: Angelo Iossa
Gianfranco Silecchia
Publication date: 01-11-2019
Publisher: Springer US
Keywords: Esophagography
Antireflux Surgery
Esophagitis
Gastroesophageal Reflux Disease
Antireflux Surgery
Dysphagia
Dysphagia
Dysphagia
Published in: Surgical Endoscopy / Issue 11/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06676-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Mid-term safety profile evaluation of Bio-A absorbable synthetic mesh as cruroplasty reinforcement

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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