title: Short-term results for laparoscopic repair of large paraesophageal hiatal hernias with Gore Bio A® mesh.
abstract: BACKGROUND
  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(®)).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain. Electronic address: papriego@hotmail.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Priego Jiménez
authors.affiliation: Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Salvador Sanchís
authors.affiliation: Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Angel
authors.affiliation: Department of General Surgery, Upper Gastrointestinal Unit, Hospital General Castellón, Avda. Benicassim s/n, 12004 Castellón, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Escrig-Sos
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control; D004146:Dioxanes; D004867:Equipment Design; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011100:Polyglycolic Acid; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004146:Dioxanes; D011100:Polyglycolic Acid; C443643:trimethylene carbonate
keywords: Dysphagia; Gore Bio A(®); Hiatal hernia; Laparoscopic antireflux surgery; Paraesophageal hernia; Prosthetic mesh; Recurrence