Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain.
Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain.
Int J Surg. 2014;12(8):794-7. doi: 10.1016/j.ijsu.2014.06.001. Epub 2014 Jun 16.
The application of mesh-reinforced hiatal closure has resulted in a significant reduction in recurrence rates in comparison with primary suture repair. One of the most debated issues is the risk of complications related to the use of the prosthesis, such as esophageal erosion and postoperative dysphagia. The aim of this study is to present our short-terms results in the treatment of laparoscopic paraesophageal hiatal hernia (LPHH) with a synthetic polyglycolic acid:trimethylene carbonate mesh (Gore Bio A(®)).
From January 2011 to December 2012, 10 patients with large paraesophageal hiatal hernias and hiatal defect over 5 cm were included. Primary simple suture of the crura and additional reinforcement with a Gore Bio A(®) mesh was performed. Hiatal hernia or gastroesophageal reflux disease (GERD) symptoms recurrence, dysphagia and mesh-related complications were investigated.
Of the 10 patients undergoing mesh repair, there were 7 women and 3 men with a mean age of 65.5 years. All operations were completed laparoscopically. Median postoperative stay was 3 days. After a median follow-up of 20.3 months, one patient developed a recurrent hiatal hernia (10%). There were no mesh-related complications.
The use of Gore Bio A(®) mesh for the laparoscopic repair of large paraesophageal hiatal hernias is safe and with a reasonably low recurrence rate in this short-term study. Additional long-term studies with ample numbers carried out for years will be necessary to see if this synthetic mesh is not only safe but also successful in the prevention of recurrences.
与初次缝合修补相比，使用网片加强的食管裂孔闭合术可显著降低复发率。最具争议的问题之一是与假体使用相关的并发症风险，如食管侵蚀和术后吞咽困难。本研究旨在介绍我们在腹腔镜食管裂孔旁疝（LPHH）治疗中应用合成聚乙二醇酸-三亚甲基碳酸酯网（Gore Bio A(®)）的短期结果。
从 2011 年 1 月至 2012 年 12 月，我们纳入了 10 例巨大食管裂孔旁疝和裂孔直径超过 5cm 的患者。采用初次单纯缝合裂孔旁的横膈脚，并附加 Gore Bio A(®)网加强。研究调查了疝或胃食管反流病（GERD）症状复发、吞咽困难和与网片相关的并发症。
在接受网片修补的 10 例患者中，有 7 例为女性，3 例为男性，平均年龄为 65.5 岁。所有手术均在腹腔镜下完成。中位术后住院时间为 3 天。中位随访 20.3 个月后，1 例患者出现复发性食管裂孔疝（10%）。无网片相关并发症。
在这项短期研究中，使用 Gore Bio A(®)网片腹腔镜修补巨大食管裂孔旁疝是安全的，且复发率相对较低。需要进行更多长期、随访多年、例数充足的研究，以确定这种合成网片不仅安全，而且在预防复发方面也是成功的。
