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Laparoscopic giant hiatal hernia repair with absorbable mesh

1 Emergency Surgery Unit, DEA Department, Careggi University Hospital, Florence, Italy
2 Sperimental and Clinical Science Department “Mario Serio”, Florence University, Florence, Italy

Correspondence Address:
Massimiliano Ardu,
Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3 50134, Florence
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_26_21

Background: The best operative approach to large hiatal hernias still remains controversial between suture cruroplasty and prosthetic hiatal herniorrhaphy. This study aims at analysing results from a single institution in Italy in terms of subjective and objective outcomes. Methods: Retrospectively collected data of all patients that underwent laparoscopic hiatal hernia repair since 2011 were considered. Sixty-five patients were included overall; 17 of them fit the criteria of large hiatal hernia. Follow-up (FU) was assessed by visit, questionnaires and X-ray imaging. Results: No major complications occurred in the post-operative course. No patient was lost during the FU period. Out of all the patients included, 13 agreed to have an X-ray with water-soluble contrast. The questionnaires showed a 76.5% rate of satisfaction (13 patients), and the recurrence rate demonstrated by radiology was 29.4% (five patients). There were no major mesh-related complications. Conclusion: The best operative approach for large hiatal hernias remains far from standardised: There is a lack of evidence on the use of a mesh for this kind of surgery as well as substantial controversy over the definition of what a giant hiatal hernia is. Nevertheless, the results from this study and the main studies in the literature seem to be encouraging in improving giant hiatal hernia repair outcomes.

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    -  Ardu M
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04