Complications of PTFE mesh at the diaphragmatic hiatus.
Paraesophageal hernia repair has been associated with a recurrence rate of up to 42%. Thus, in the last decade, there has been increasing interest in the use of mesh reinforcement of the hiatal repair. Polytetrafluoroethylene (PTFE) is one of the materials that have been used for this purpose, as it is thought to induce minimal tissue reaction. We report two cases in which complications specific to the use of PTFE mesh in this location developed over time. In the first patient, a gastrectomy was required to remove a large PTFE mesh which had eroded into the esophagogastric junction and gastric cardia. The second patient experienced severe dysphagia resulting from a stricture caused by the implant, requiring removal of the mesh. Although such complications have only rarely been reported, the severity and consequences of these incidents, as reported in the literature and in light of our observations, suggest that an alternative to PTFE should be considered for crural reinforcement during paraesophageal hernia repair.
Tatum
Roger P
RP
Department of Surgery, University of Washington, VA Puget Sound Health Care System, 1660 South Columbian Way, s-112-gs, Seattle, WA 98108, USA. rtatum@u.washington.edu
Shalhub
Sherene
S
Oelschlager
Brant K
BK
Pellegrini
Carlos A
CA
D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D003964:Diaphragm / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000601:surgery; D006551:Hernia, Hiatal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012008:Recurrence; D012086:Reoperation; D013270:Stomach; D013526:Surgical Mesh / Q000009:adverse effects*
D011138:Polytetrafluoroethylene