[The use of allografts in the surgical treatment of enlarged hiatal hernias].
The use of allografts in the surgical treatment of enenlarged hiatal hernias is a current hot topic of discussion. Using meshes in order to strengthen the hiatus of the esophagus is an efficient procedure which reduces the risk of reoccurences. In order to consolidate the initial surgical treatment of the enlarged hiatal hernias, polypropylene, polytetrafluoroethylene and biomaterial meshes are mainly used. There are ongoing discussions with regards to the use of meshes, their type and positioning. Although mesh usage is associated with a low recurrence rate, numerous authors have described complications such as: meshes migrating into the esophagus (caused by the alloplastic material used in the hiatoplasty), strictures, dysphagia, ulcers or perforations. From experience, the mesh used in the surgical treatment of hiatal hernia should preferably be non-biological and must be placed circumferentially, while fermly grounded at the pillar of the diaphragm. The correct placing of the mesh lowers the risk of strictures and degradation. Further prospective studies are needed in order to clarify the best method of surgically treating enlarged hiatal hernias.
Sectia Chirurgie I, Spitalul Universitar de Urgenţă Militar Central Carol Davila, Bucureşti, România. drmtanase@yahoo.com
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D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery*; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D011817:Rabbits; D013526:Surgical Mesh; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011126:Polypropylenes; D011138:Polytetrafluoroethylene