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Prosthetic mesh repair of large and recurrent diaphragmatic hernias

LUBEZKY, Nir ; SAGIE, Boaz ; KEIDAR, Andrei ; SZOLD, Amir

Surgical endoscopy, 2007-05, Vol.21 (5), p.737-741 [Peer Reviewed Journal]

New York, NY: Springer

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Title:
Prosthetic mesh repair of large and recurrent diaphragmatic hernias
Author: LUBEZKY, Nir ; SAGIE, Boaz ; KEIDAR, Andrei ; SZOLD, Amir
Subjects: Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Digestive system. Abdomen ; Dissection ; Endoscopy ; Esophagus ; Feasibility Studies ; Female ; Follow-Up Studies ; Gastrointestinal Diseases - etiology ; Hernia, Diaphragmatic - surgery ; Hernia, Hiatal - complications ; Hernia, Hiatal - surgery ; Hiatal hernias ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy ; Male ; Medical sciences ; Middle Aged ; Orthopedic surgery ; Prostheses ; Reoperation ; Secondary Prevention ; Surgeons ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Mesh ; Sutures ; Treatment Outcome
Is Part Of: Surgical endoscopy, 2007-05, Vol.21 (5), p.737-741
Notes: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Description: Laparoscopic repair of large paraesophageal hernias (PEH) is associated with significant recurrence rates. Use of prosthetic mesh to complete tension-free repair of the hiatus has been suggested to decrease the recurrence rate. Fifty-nine patients with large (n = 44) or recurrent (n = 15) PEH were operated on via the laparoscopic approach with the use of prosthetic mesh. Patients were followed with office visits and phone interviews. All patients were referred for barium studies. Data analysis included all patients, including conversions, on an intention-to-treat basis. Followup was completed in 56 (95%) patients. Mean followup time was 28.4 months. Forty patients (74%) had significant relief of all symptoms. Barium studies were performed in 45 patients (80.3%), including all symptomatic patients. Fifteen patients (33%) had a small sliding hernia, six (13.3%) had recurrent PEH, and four (8.8%) had narrowing of the gastroesophageal junction. Most patients with small hiatal hernias were symptomatic (60%). All responded to medical treatment. Laparoscopic repair of large PEH with reinforcement mesh is feasible and safe with excellent short-term results. Long-term followup shows a low PEH recurrence requiring reoperation, but a significant number of patients develop symptomatic recurrent small hiatal hernias that can be managed nonoperatively.
Publisher: New York, NY: Springer
Language: English

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Prosthetic mesh repair of large and recurrent diaphragmatic hernias

LUBEZKY, Nir ; SAGIE, Boaz ; KEIDAR, Andrei ; SZOLD, Amir

New York, NY: Springer

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