Laparoscopic repair of paraesophageal hernia with selective use of mesh.
The laparoscopic approach to PEH, in use for close to a decade, shows promising results. However, data on the long-term follow-up of patients who undergo this procedure are still lacking, and the use of mesh is debatable. We retrospectively investigated 33 patients who underwent this procedure over a 30-month period. In 10 patients, the repair was performed using a mesh prosthesis. There was one (3%) intraoperative and four (12%) early postoperative complications, with one mortality (3%). The average postoperative stay was 3 days. During a 58-month follow-up period, 18% of the patients developed small, sliding recurrent hernias, with a higher rate in the primary repair group (18% vs. 10%). Surgical outcome was scored good-to-excellent on a questionnaire by 84.5% of the patients. Laparoscopic repair of PEH is feasible and safe. While small recurrences do occur, functional results remain good. The use of mesh should be tailored to the specific patient.
Keidar
Andrei
A
Department of Surgery B, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Szold
Amir
A
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects*; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013526:Surgical Mesh / Q000009:adverse effects*; D013997:Time Factors