Open AccessUse of Polypropylene Strips for Reinforcement of the Cruroplasty in Laparoscopic Paraesophageal Hernia Repair: A Retrospective Cohort Study
Author(s) -
L. Matthijs Van den Dop,
Gijs H J de Smet,
Aziz Mamound,
Johan F. Lange,
Bas P. L. Wijnhoven,
Willem E. Hueting
Publication year - 2021
Publication title -
digestive surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.762
H-Index - 69
eISSN - 1421-9883
pISSN - 0253-4886
DOI - 10.1159/000518182
Subject(s) - medicine , surgery , hernia , interquartile range , retrospective cohort study , hiatal hernia , hernia repair , laparoscopy , endoscopy , complication , general surgery , disease , reflux
Laparoscopic paraesophageal hernia repair is an effective treatment for symptomatic paraesophageal hernias. To reduce recurrence rates, the use of prosthetics for the crural repair has been suggested. Mesh-related complications are rare but known to be disastrous. To address another form of crural repair, polypropylene strips are suggested. This study aimed to assess peri- and postoperative complications of reinforcement of cruroplasty with polypropylene strips. Methods: From 2013 to 2020, patients with a primary or recurrent type 2, 3, or 4 paraesophageal hernia that underwent cruroplasty with polypropylene strips were retrospectively reviewed. Intra- and postoperative complications were graded according to the Clavien-Dindo classification. The incidence of symptomatic recurrent hiatal hernia (CT or endoscopy proven) and hospital stay were assessed. Results: One hundred fifty-eight patients were included. Mean age was 65 years (standard deviation 10.4), and 119 patients were female (75.3%). Almost 50% of surgeries took place between 2018 and 2020. Median follow-up was 7 months (interquartile range 17.5). Mean operation time in the primary hernia group was 159 min (standard deviation 39.0), and length of stay was 4.4 days. In 3/158 patients (2.0%), intraoperative complications occurred. Two patients developed a grade 4 and seven patients a grade 3 postoperative complication. No mortality was recorded. Twelve recurrences (8.2%) were detected in the primary hernia group and one (9.1%) in the recurrent hernia group. Conclusion: There were no mesh-related complications seen and symptomatic recurrence rate was low, but longer follow-up is needed.