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Портал Begell Электронная Бибилиотека e-Книги Журналы Справочники и Сборники статей Коллекции
Journal of Long-Term Effects of Medical Implants
SJR: 0.133 SNIP: 0.491 CiteScore™: 0.89

ISSN Печать: 1050-6934
ISSN Онлайн: 1940-4379

Выпуски:
Том 29, 2019 Том 28, 2018 Том 27, 2017 Том 26, 2016 Том 25, 2015 Том 24, 2014 Том 23, 2013 Том 22, 2012 Том 21, 2011 Том 20, 2010 Том 19, 2009 Том 18, 2008 Том 17, 2007 Том 16, 2006 Том 15, 2005 Том 14, 2004 Том 13, 2003 Том 12, 2002 Том 11, 2001 Том 10, 2000

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v20.i2.70
pages 139-148

Repair of the Giant Hiatal Hernia

Sean R. Sheff
Department of Medical Education, Gundersen Lutheran Medical Foundation, La Crosse, WI, USA
Shanu N. Kothari
Department of General and Vascular Surgery, Gundersen Lutheran Health System, La Crosse, WI, USA

Краткое описание

The repair of hiatal hernias, specifically giant hiatal hernias, is technically challenging and controversial. The approach to repair has shifted from thoracic to open abdominal to laparoscopic, which appears to be the current standard. High recurrence rates have been reported with laparoscopic procedures, but these are anatomic recurrences that are largely asymptomatic. Symptomatic recurrences with laparoscopic procedures appear to be similar to those seen with open abdominal procedures, but without the additional morbidity conferred by laparotomy. In the last decade, several studies have reported improved rates of recurrence using prosthetic meshes that have decreased even radiologic recurrence rates to below 5%. However, this has come at the price of rare but serious complications such as erosion and fibrosis. Mesh repair appears to be associated with a higher perioperative rate of dysphagia, which tends to resolve within the intervening months. Biologic meshes have been implemented in an attempt to obtain the buttressing effect of prosthetic meshes without the complications of erosion or infection. Early results have not proven biologic meshes to be as effective in reducing recurrence rates as prosthetic meshes, but there are currently no reports of erosion. Continued research is needed to elicit the optimal type of repair and mesh.


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