title: Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias.
abstract: The utility of mesh reinforcement for small hiatal hernia found especially during antireflux surgery is unknown. Initial reports for the use of biological mesh for crural reinforcement during repair for defects greater than 5 cm have been shown to decrease recurrence rates. This study compares patients with small hiatal hernias who underwent onlay biologic mesh buttress repair versus those with suture cruroplasty alone. This is a single-institution retrospective review of all patients undergoing repair of hiatal hernia measuring 1-5 cm between 2002 and 2009. The patients were evaluated based on surgical repair: one group undergoing crural reinforcement with onlay biologic mesh and other group with suture cruroplasty only. Seventy patients with hiatal hernia measuring 1-5 cm were identified. Thirty-eight patients had hernia repair with biologic mesh, and 32 patients had repair with suture cruroplasty only. Recurrence rate at 1 year was 16% (5/32) in patients who had suture cruroplasty only and 0% (0/38) in the group with crural reinforcement with absorbable mesh (statistically significant, P = 0.017). Suture cruroplasty alone appears to be inadequate for hiatal hernias measuring 1-5 cm with significant recurrence rate and failure of antireflux surgery. Crural reinforcement with absorbable mesh may reduce hiatal hernia recurrence rate in small hiatal hernias.
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors: E
authors: E
authors: Schmidt
authors: A
authors: A
authors: Shaligram
authors: J F
authors: JF
authors: Reynoso
authors: V
authors: V
authors: Kothari
authors: D
authors: D
authors: Oleynikov
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D001672:Biocompatible Materials; D015331:Cohort Studies; D003964:Diaphragm / Q000601:surgery*; D005260:Female; D006551:Hernia, Hiatal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials
keywords: biologic mesh; hiatal hernia; laparoscopy; paraesophageal