Posted on 10/30/2023 10:21:22 AM PDT by ConservativeMind
Researchers have conducted a long-term study regarding the use of mesh reinforcement in hiatal hernia repair for patients with gastroesophageal reflux disease (GERD).
In a paper, the team details their assessment that there is no significant difference between mesh reinforcement and crural sutures alone in reducing hiatal hernia recurrence in patients with GERD.
The study cohort included 103 patients with chronic GERD randomly assigned to two groups, one with mesh reinforcement and one with crural sutures alone. The data for analysis were obtained after more than 10 years of follow-up, with a mean follow-up time of 13 years.
The double-blind, randomized clinical trial was conducted at Ersta Hospital in Stockholm, Sweden, from January 2006 to December 2010. Patients with GERD and hiatal hernias longer than 2 cm were included and randomized into the two groups.
Hiatal hernia repair techniques involved crural sutures alone or tension-free reinforcement with a nonabsorbable polytetrafluoroethylene mesh. Primary outcomes looked for radiologically verified hiatal hernia recurrence after more than 10 years, and secondary outcomes included dysphagia scores, health-related quality of life, proton pump inhibitor consumption, and reoperation rates.
The radiologically verified hiatal hernia recurrence rates were 38% for the mesh group and 31% for the suture group, a difference that is not statistically significant. The two groups did not significantly differ in quality of life, reflux symptoms, and proton pump inhibitor consumption.
Dysphagia scores for solid foods remained significantly higher in the mesh group at 13 years postoperatively, which the authors suggest may indicate a time-dependent increased risk of mechanical complications associated with mesh reinforcement.
Highlighting the long-term outcomes of hiatal hernia repair techniques in patients with GERD, the study suggests that tension-free polytetrafluoroethylene mesh closure is not recommended as a routine practice in laparoscopic hiatal hernia repair for GERD.
(Excerpt) Read more at medicalxpress.com ...
Buddy of mine just had mesh installed this summer.
What about STAPLES?.....................
One of the big issues with fundoplication surgery is when the GE junction is made TOO tight. I’ve seen patients who were in horrible pain because they couldn’t ‘burp’, and had markedly distended stomachs.
What about mesh for ventral, umbilical, and inguinal hernias?
My BIL had it done and wished he hadn’t.
I had three or four meshes put in before one finally took. 20 years later there’s small hernias appearing. not sure that I’m going to do anything about them.
And meshes really hurt when they give way.
Had to clean my glasses. I thought it said “METH”
My son went to the Sholdice clinic in Ontario for umbilical hernia repair. Only place he could find that would do.it without mesh. They do nothing but hernia repair, no mesh.
One of my contractors is currently suffering from both an umbilical and an inguinal hernia, plus gallstones. His surgeon doesn’t think the opening in the inguinal hernia is large enough to warrant surgery, yet the external swelling is worse and he’s in pain. How large must the hole be before the surgeon would operate?
I’m headed to Duke University Hospital for 4 at once. 2 ventral, 1 umbilical, and 1 inguinal.
I’m tired of my small intestines going through the holes and pinching off. It will bring a strong man to his knees. Has happened three times already and I fixed it with my finger after much pain.
They were not from bullet holes! But they feel like them.
My inguinal gave me a scrotum the size of a softball. The inguinal is small, but needs to be repaired as it leaks.
Studies have pointed to ox bile/TUDCA as helping to emulsify the stones.
After a few months of it, a follow up second scan showed what we knew, that they were gone.
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