Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series
Background Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed. Methods We compiled two cases, and our s...
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| Veröffentlicht in: | Surgical endoscopy 2009-06, Vol.23 (6), p.1219-1226 |
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| creator | Stadlhuber, Rudolf J. Sherif, Amr El Mittal, Sumeet K. Fitzgibbons, Robert J. Michael Brunt, L. Hunter, John G. DeMeester, Tom R. Swanstrom, Lee L. Daniel Smith, C. Filipi, Charles J. |
| description | Background
Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed.
Methods
We compiled two cases, and our senior author contacted other experienced esophageal surgeons who provided 26 additional cases with mesh-related complications. Care was taken to retrieve technical operative details concerning mesh size and shape and implantation technique used.
Results
Twenty-six patients underwent laparoscopic and two patients open surgery for large hiatal hernia (
n
= 28). Twenty-five patients had a concomitant Nissen fundoplication, two a Toupet fundoplication, and one a Watson fundoplication. Mesh types placed were polypropylene (
n
= 8), polytetrafluoroethylene (PTFE) (
n
= 12), biological mesh (
n
= 7), and dual mesh (
n
= 1). Presenting symptoms associated with mesh complications were dysphagia (
n
= 22), heartburn (
n
= 10), chest pain (
n
= 14), fever (
n
= 1), epigastric pain (
n
= 2), and weight loss (
n
= 4). Main reoperative findings were intraluminal mesh erosion (
n
= 17), esophageal stenosis (
n
= 6), and dense fibrosis (
n
= 5). Six patients required esophagectomy, two patients had partial gastrectomy, and 1 patient had total gastrectomy. Five patients did not require surgery. In this group one patient had mesh removal by endoscopy. There was no immediate postoperative mortality, however one patient has severe gastroparesis and five patients are dependent on tube feeding. Two patients died 3 months postoperatively of unknown cause. There is no apparent relationship between mesh type and configuration with the complications encountered.
Conclusion
Complications related to synthetic mesh placement at the esophageal hiatus are more common than previously reported. Multicenter prospective studies are needed to determine the best method and type of mesh for implantation. |
| doi_str_mv | 10.1007/s00464-008-0205-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67292618</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67292618</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-f2a25746c4f70e4ddc2bf19faf9951608c48b41d99ebfbdd72d856e94b658b53</originalsourceid><addsrcrecordid>eNp10D1vFDEQBmALgcgl8ANokIVEOidjn-1d00URX1JQmlBbXu-Yc7Qfh2e3yL_HpzsRCYnKhR-P33kZeyfhSgI01wSgrRYArQAFRpgXbCP1VgmlZPuSbcBtQajG6TN2TvQIlTtpXrMz6cA20OgN-_kDacfjPO6HHMOS54l4SAsWvi8zLTtccuQF85TmEnHEaeFz4rscljDwOMy0FvzEA1etiIGQE5aM9Ia9SmEgfHs6L9jDl88Pt9_E3f3X77c3dyJqaxaRVFCm0Tbq1ADqvo-qS9KlkJwz0kIbddtp2TuHXer6vlF9ayw63VnTdmZ7wS6PY2vW3yvS4sdMEYchTDiv5G2jnLKyrfDDP_BxXstUo3klnTaudaoieUSxbk4Fk9-XPIby5CX4Q9_-2LevfftD3_6Q4P1p8NqN2D-_OBVcwccTCBTDkEqYYqa_TkmrQdptderoqF5Nv7A8J_z_738AHUWXkA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219459892</pqid></control><display><type>article</type><title>Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Stadlhuber, Rudolf J. ; Sherif, Amr El ; Mittal, Sumeet K. ; Fitzgibbons, Robert J. ; Michael Brunt, L. ; Hunter, John G. ; DeMeester, Tom R. ; Swanstrom, Lee L. ; Daniel Smith, C. ; Filipi, Charles J.</creator><creatorcontrib>Stadlhuber, Rudolf J. ; Sherif, Amr El ; Mittal, Sumeet K. ; Fitzgibbons, Robert J. ; Michael Brunt, L. ; Hunter, John G. ; DeMeester, Tom R. ; Swanstrom, Lee L. ; Daniel Smith, C. ; Filipi, Charles J.</creatorcontrib><description>Background
Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed.
Methods
We compiled two cases, and our senior author contacted other experienced esophageal surgeons who provided 26 additional cases with mesh-related complications. Care was taken to retrieve technical operative details concerning mesh size and shape and implantation technique used.
Results
Twenty-six patients underwent laparoscopic and two patients open surgery for large hiatal hernia (
n
= 28). Twenty-five patients had a concomitant Nissen fundoplication, two a Toupet fundoplication, and one a Watson fundoplication. Mesh types placed were polypropylene (
n
= 8), polytetrafluoroethylene (PTFE) (
n
= 12), biological mesh (
n
= 7), and dual mesh (
n
= 1). Presenting symptoms associated with mesh complications were dysphagia (
n
= 22), heartburn (
n
= 10), chest pain (
n
= 14), fever (
n
= 1), epigastric pain (
n
= 2), and weight loss (
n
= 4). Main reoperative findings were intraluminal mesh erosion (
n
= 17), esophageal stenosis (
n
= 6), and dense fibrosis (
n
= 5). Six patients required esophagectomy, two patients had partial gastrectomy, and 1 patient had total gastrectomy. Five patients did not require surgery. In this group one patient had mesh removal by endoscopy. There was no immediate postoperative mortality, however one patient has severe gastroparesis and five patients are dependent on tube feeding. Two patients died 3 months postoperatively of unknown cause. There is no apparent relationship between mesh type and configuration with the complications encountered.
Conclusion
Complications related to synthetic mesh placement at the esophageal hiatus are more common than previously reported. Multicenter prospective studies are needed to determine the best method and type of mesh for implantation.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-008-0205-5</identifier><identifier>PMID: 19067074</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Biological and medical sciences ; Case reports ; Dysphagia ; Esophagus ; Gastroenterology ; Gastrointestinal surgery ; General aspects ; Gynecology ; Hepatology ; Hernia, Hiatal - surgery ; Hiatal hernias ; Humans ; Laparoscopy ; Laparoscopy - methods ; Medical sciences ; Medicine ; Medicine & Public Health ; Orthopedic surgery ; Patients ; Postoperative Complications - etiology ; Proctology ; Prostheses ; Prosthesis Failure ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgical Mesh - adverse effects</subject><ispartof>Surgical endoscopy, 2009-06, Vol.23 (6), p.1219-1226</ispartof><rights>Springer Science+Business Media, LLC 2008</rights><rights>2009 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-f2a25746c4f70e4ddc2bf19faf9951608c48b41d99ebfbdd72d856e94b658b53</citedby><cites>FETCH-LOGICAL-c465t-f2a25746c4f70e4ddc2bf19faf9951608c48b41d99ebfbdd72d856e94b658b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-008-0205-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-008-0205-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21640163$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19067074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stadlhuber, Rudolf J.</creatorcontrib><creatorcontrib>Sherif, Amr El</creatorcontrib><creatorcontrib>Mittal, Sumeet K.</creatorcontrib><creatorcontrib>Fitzgibbons, Robert J.</creatorcontrib><creatorcontrib>Michael Brunt, L.</creatorcontrib><creatorcontrib>Hunter, John G.</creatorcontrib><creatorcontrib>DeMeester, Tom R.</creatorcontrib><creatorcontrib>Swanstrom, Lee L.</creatorcontrib><creatorcontrib>Daniel Smith, C.</creatorcontrib><creatorcontrib>Filipi, Charles J.</creatorcontrib><title>Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed.
Methods
We compiled two cases, and our senior author contacted other experienced esophageal surgeons who provided 26 additional cases with mesh-related complications. Care was taken to retrieve technical operative details concerning mesh size and shape and implantation technique used.
Results
Twenty-six patients underwent laparoscopic and two patients open surgery for large hiatal hernia (
n
= 28). Twenty-five patients had a concomitant Nissen fundoplication, two a Toupet fundoplication, and one a Watson fundoplication. Mesh types placed were polypropylene (
n
= 8), polytetrafluoroethylene (PTFE) (
n
= 12), biological mesh (
n
= 7), and dual mesh (
n
= 1). Presenting symptoms associated with mesh complications were dysphagia (
n
= 22), heartburn (
n
= 10), chest pain (
n
= 14), fever (
n
= 1), epigastric pain (
n
= 2), and weight loss (
n
= 4). Main reoperative findings were intraluminal mesh erosion (
n
= 17), esophageal stenosis (
n
= 6), and dense fibrosis (
n
= 5). Six patients required esophagectomy, two patients had partial gastrectomy, and 1 patient had total gastrectomy. Five patients did not require surgery. In this group one patient had mesh removal by endoscopy. There was no immediate postoperative mortality, however one patient has severe gastroparesis and five patients are dependent on tube feeding. Two patients died 3 months postoperatively of unknown cause. There is no apparent relationship between mesh type and configuration with the complications encountered.
Conclusion
Complications related to synthetic mesh placement at the esophageal hiatus are more common than previously reported. Multicenter prospective studies are needed to determine the best method and type of mesh for implantation.</description><subject>Abdominal Surgery</subject><subject>Biological and medical sciences</subject><subject>Case reports</subject><subject>Dysphagia</subject><subject>Esophagus</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernia, Hiatal - surgery</subject><subject>Hiatal hernias</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedic surgery</subject><subject>Patients</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Prostheses</subject><subject>Prosthesis Failure</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgical Mesh - adverse effects</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp10D1vFDEQBmALgcgl8ANokIVEOidjn-1d00URX1JQmlBbXu-Yc7Qfh2e3yL_HpzsRCYnKhR-P33kZeyfhSgI01wSgrRYArQAFRpgXbCP1VgmlZPuSbcBtQajG6TN2TvQIlTtpXrMz6cA20OgN-_kDacfjPO6HHMOS54l4SAsWvi8zLTtccuQF85TmEnHEaeFz4rscljDwOMy0FvzEA1etiIGQE5aM9Ia9SmEgfHs6L9jDl88Pt9_E3f3X77c3dyJqaxaRVFCm0Tbq1ADqvo-qS9KlkJwz0kIbddtp2TuHXer6vlF9ayw63VnTdmZ7wS6PY2vW3yvS4sdMEYchTDiv5G2jnLKyrfDDP_BxXstUo3klnTaudaoieUSxbk4Fk9-XPIby5CX4Q9_-2LevfftD3_6Q4P1p8NqN2D-_OBVcwccTCBTDkEqYYqa_TkmrQdptderoqF5Nv7A8J_z_738AHUWXkA</recordid><startdate>20090601</startdate><enddate>20090601</enddate><creator>Stadlhuber, Rudolf J.</creator><creator>Sherif, Amr El</creator><creator>Mittal, Sumeet K.</creator><creator>Fitzgibbons, Robert J.</creator><creator>Michael Brunt, L.</creator><creator>Hunter, John G.</creator><creator>DeMeester, Tom R.</creator><creator>Swanstrom, Lee L.</creator><creator>Daniel Smith, C.</creator><creator>Filipi, Charles J.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20090601</creationdate><title>Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series</title><author>Stadlhuber, Rudolf J. ; Sherif, Amr El ; Mittal, Sumeet K. ; Fitzgibbons, Robert J. ; Michael Brunt, L. ; Hunter, John G. ; DeMeester, Tom R. ; Swanstrom, Lee L. ; Daniel Smith, C. ; Filipi, Charles J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-f2a25746c4f70e4ddc2bf19faf9951608c48b41d99ebfbdd72d856e94b658b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdominal Surgery</topic><topic>Biological and medical sciences</topic><topic>Case reports</topic><topic>Dysphagia</topic><topic>Esophagus</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Hiatal - surgery</topic><topic>Hiatal hernias</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedic surgery</topic><topic>Patients</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Prostheses</topic><topic>Prosthesis Failure</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgical Mesh - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stadlhuber, Rudolf J.</creatorcontrib><creatorcontrib>Sherif, Amr El</creatorcontrib><creatorcontrib>Mittal, Sumeet K.</creatorcontrib><creatorcontrib>Fitzgibbons, Robert J.</creatorcontrib><creatorcontrib>Michael Brunt, L.</creatorcontrib><creatorcontrib>Hunter, John G.</creatorcontrib><creatorcontrib>DeMeester, Tom R.</creatorcontrib><creatorcontrib>Swanstrom, Lee L.</creatorcontrib><creatorcontrib>Daniel Smith, C.</creatorcontrib><creatorcontrib>Filipi, Charles J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stadlhuber, Rudolf J.</au><au>Sherif, Amr El</au><au>Mittal, Sumeet K.</au><au>Fitzgibbons, Robert J.</au><au>Michael Brunt, L.</au><au>Hunter, John G.</au><au>DeMeester, Tom R.</au><au>Swanstrom, Lee L.</au><au>Daniel Smith, C.</au><au>Filipi, Charles J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2009-06-01</date><risdate>2009</risdate><volume>23</volume><issue>6</issue><spage>1219</spage><epage>1226</epage><pages>1219-1226</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed.
Methods
We compiled two cases, and our senior author contacted other experienced esophageal surgeons who provided 26 additional cases with mesh-related complications. Care was taken to retrieve technical operative details concerning mesh size and shape and implantation technique used.
Results
Twenty-six patients underwent laparoscopic and two patients open surgery for large hiatal hernia (
n
= 28). Twenty-five patients had a concomitant Nissen fundoplication, two a Toupet fundoplication, and one a Watson fundoplication. Mesh types placed were polypropylene (
n
= 8), polytetrafluoroethylene (PTFE) (
n
= 12), biological mesh (
n
= 7), and dual mesh (
n
= 1). Presenting symptoms associated with mesh complications were dysphagia (
n
= 22), heartburn (
n
= 10), chest pain (
n
= 14), fever (
n
= 1), epigastric pain (
n
= 2), and weight loss (
n
= 4). Main reoperative findings were intraluminal mesh erosion (
n
= 17), esophageal stenosis (
n
= 6), and dense fibrosis (
n
= 5). Six patients required esophagectomy, two patients had partial gastrectomy, and 1 patient had total gastrectomy. Five patients did not require surgery. In this group one patient had mesh removal by endoscopy. There was no immediate postoperative mortality, however one patient has severe gastroparesis and five patients are dependent on tube feeding. Two patients died 3 months postoperatively of unknown cause. There is no apparent relationship between mesh type and configuration with the complications encountered.
Conclusion
Complications related to synthetic mesh placement at the esophageal hiatus are more common than previously reported. Multicenter prospective studies are needed to determine the best method and type of mesh for implantation.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19067074</pmid><doi>10.1007/s00464-008-0205-5</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2009-06, Vol.23 (6), p.1219-1226 |
| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Biological and medical sciences Case reports Dysphagia Esophagus Gastroenterology Gastrointestinal surgery General aspects Gynecology Hepatology Hernia, Hiatal - surgery Hiatal hernias Humans Laparoscopy Laparoscopy - methods Medical sciences Medicine Medicine & Public Health Orthopedic surgery Patients Postoperative Complications - etiology Proctology Prostheses Prosthesis Failure Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgical Mesh - adverse effects |
| title | Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series |
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