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CLINICAL EVALUATION OF LAPAROSCOPIC REPAIR OF LARGE HIATAL HERNIAS WITH T i M esh
Author(s) -
Hazebroek Eric J.,
Ng Ada,
Yong David H. K.,
Berry Hayley,
Leibman Steven,
Smith Garett S.
Publication year - 2008
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2008.04691.x
Subject(s) - medicine , hiatal hernia , dysphagia , surgery , quality of life (healthcare) , hernia , fibrous joint , laparoscopy , patient satisfaction , hernia repair , surgical mesh , gastroesophageal junction , reflux , disease , nursing , adenocarcinoma , cancer
The use of mesh for laparoscopic repair of large hiatal hernias may decrease recurrence rates in comparison with primary suture repair. The type of mesh material, as well as its size and shape, is still a matter of debate. The aim of this study was to evaluate a lightweight polypropylene mesh (TiMesh) repair of hiatal hernias, with particular reference to symptomatic relief, patient satisfaction and quality of life (QOL). From a prospectively maintained clinical database, 40 consecutive patients were identified who underwent elective laparoscopic hiatal hernia repair with TiMesh between November 2004 and December 2006. QOL and symptom analysis was carried out using Quality of Life in Reflux and Dyspepsia (QOLRAD) and dysphagia questionnaires preoperatively, and postoperatively after 6 weeks, 6 months, and 1 year. The mean age of the patient was 65.2 years (range: 40–93 years). Total complication rate was 7.5%; all complications were treated without residual disability. There was no 30‐day mortality. Median hospital stay was 2.7 days (range 2–13 days). Completed questionnaires were obtained from 37 (92.5%) of 40 patients. After 1 year, more than 90% of patients were satisfied with their symptomatic outcome and regarded their surgery as successful. There was a significant improvement in QOL, measured with QOLRAD at all postoperative time‐points ( P < 0.001). There was no difference between pre‐ and postoperative dysphagia scores. Laparoscopic repair of large hiatal hernias with TiMesh yields good symptomatic and clinical outcome. Further studies are needed to show whether the use of this lightweight polypropylene mesh is associated with a reduction in recurrence rates after hiatal hernia repair in the longer term.