Risk factors associated with radiological and clinical recurrences after laparoscopic repair of large hiatal hernia with TiO 2 Mesh™ reinforcement.

Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE

Original Publication: Paris, France : Springer, c1997-

Hernia, Hiatal*/surgery ; Titanium* ; Surgical Mesh*/adverse effects ; Laparoscopy*/adverse effects ; Herniorrhaphy*/adverse effects ; Herniorrhaphy*/methods ; Recurrence*; Humans ; Male ; Female ; Aged ; Retrospective Studies ; Middle Aged ; Risk Factors ; Aged, 80 and over ; Polypropylenes

Introduction: Laparoscopic repair of large para-esophageal hiatal hernias (LPHH) remains controversial. Several meta-analyses suggest hiatus reinforcement with mesh has better outcomes over cruroplasty in terms of less recurrence. The aim of this study was to evaluate the medium-term results of treating LPHH with a biosynthetic monofilament polypropylene mesh coated with titanium dioxide to enhance biocompatibility (TiO 2 Mesh™).
Methods: A retrospective observational study, using data extracted from a prospectively collected database was performed at XXX from December 2014 to June 2023. Included participants were all patients who underwent laparoscopic repair of large (> 5 cm) type III hiatal hernia in which a TiO 2 Mesh™ was used. The results of the study, including clinical and radiological recurrences as well as mesh-related morbidity, were analyzed.
Results: Sixty-seven patients were finally analyzed. Laparoscopic approach was attempted in all but conversion was needed in one patient because of bleeding in the lesser curvature. With a median follow-up of 41 months (and 10 losses to follow-up), 22% of radiological recurrences and 19.3% of clinical recurrences were described. Regarding complications, one patient presented morbidity associated with the mesh (mesh erosion requiring endoscopic extraction). Recurrent hernia repair was an independent factor of clinical recurrence (OR 4.57 95% CI (1.28-16.31)).
Conclusion: LPHH with TiO 2 Mesh™ is safe and feasible with a satisfactory medium-term recurrence and a low complication rate. Prospective randomized studies are needed to establish the standard repair of LPHH.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Comment on: J Laparoendosc Adv Surg Tech A. 2021 Oct;31(10):1118-1123. doi: 10.1089/lap.2020.0752. (PMID: 33332239)

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Keywords: Hiatal hernia; Hiatus; Laparoscopic; Mesh; Non-absorbable; Recurrence; TiO2Mesh™; Titanium

D1JT611TNE (Titanium)
15FIX9V2JP (titanium dioxide)
0 (Polypropylenes)

Date Created: 20240713 Date Completed: 20241003 Latest Revision: 20241107

20241107

10.1007/s10029-024-03107-8

39001940