J Li1, T Cheng2. 1. Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China. Lijunshenghd@126.com. 2. Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Abstract
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate, which has led to the use of mesh for crural repair. However, severe mesh-related complications, including esophageal or gastric erosion, have been observed. METHODS: In the present study, we made a thorough identification of all published reports on the esophageal or gastric mesh erosion or migration after hiatal hernia repair. The incidence, site, mesh type, latent interval, consequence and treatment methods of mesh erosion were summarized and analyzed. RESULTS: A total of 50 cases of esophageal or gastric mesh erosion or migration after hiatal hernia repair were reported since 1998. A higher erosion rate was observed in recurrent hiatal hernia repair. The most common erosion site was esophagus (50%), followed by stomach (25%) and gastric-esophageal junction (GEJ) (23%). The most common mesh types reported in this series were PTEF and polypropylene. The duration from the hernia repair to the identification of erosion varied greatly, and 79% of the erosion occurred within 2 years after the hernia repair. Various treatment methods were reported, including endoscopic mesh retrieval (15.7%), laparoscopic mesh removal (11.8%), surgical mesh removal (19.6%); however, distal esophageal resection and gastric resection were reported in 19.6% and 5.9%, respectively. Some patients had to receive tube feeding. CONCLUSION: The true incidence of mesh erosion after hiatal hernia repair may be higher than previously reported, and the erosion is more prone to occur after recurrent hiatal hernia repair. Mesh erosion can result in severe morbidity and sometimes require complex organ resection. Different kinds and shapes of prosthetic meshes can cause erosion; therefore, mesh should be used very selectively for hiatal hernia repair. The patient should be informed about the mesh placement and the possible mesh-related complications.
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate, which has led to the use of mesh for crural repair. However, severe mesh-related complications, including esophageal or gastric erosion, have been observed. METHODS: In the present study, we made a thorough identification of all published reports on the esophageal or gastric mesh erosion or migration after hiatal hernia repair. The incidence, site, mesh type, latent interval, consequence and treatment methods of mesh erosion were summarized and analyzed. RESULTS: A total of 50 cases of esophageal or gastric mesh erosion or migration after hiatal hernia repair were reported since 1998. A higher erosion rate was observed in recurrent hiatal hernia repair. The most common erosion site was esophagus (50%), followed by stomach (25%) and gastric-esophageal junction (GEJ) (23%). The most common mesh types reported in this series were PTEF and polypropylene. The duration from the hernia repair to the identification of erosion varied greatly, and 79% of the erosion occurred within 2 years after the hernia repair. Various treatment methods were reported, including endoscopic mesh retrieval (15.7%), laparoscopic mesh removal (11.8%), surgical mesh removal (19.6%); however, distal esophageal resection and gastric resection were reported in 19.6% and 5.9%, respectively. Some patients had to receive tube feeding. CONCLUSION: The true incidence of mesh erosion after hiatal hernia repair may be higher than previously reported, and the erosion is more prone to occur after recurrent hiatal hernia repair. Mesh erosion can result in severe morbidity and sometimes require complex organ resection. Different kinds and shapes of prosthetic meshes can cause erosion; therefore, mesh should be used very selectively for hiatal hernia repair. The patient should be informed about the mesh placement and the possible mesh-related complications.
Authors: Pedro Hergueta-Delgado; Miguel Marin-Moreno; Salvador Morales-Conde; Sara Reina-Serrano; Cinta Jurado-Castillo; Francisco Pellicer-Bautista; Juan-Manuel Herrerias-Gutierrez Journal: Gastrointest Endosc Date: 2006-07 Impact factor: 9.427
Authors: M Hashemi; J H Peters; T R DeMeester; J E Huprich; M Quek; J A Hagen; P F Crookes; J Theisen; S R DeMeester; L F Sillin; C G Bremner Journal: J Am Coll Surg Date: 2000-05 Impact factor: 6.113
Authors: W A Gantert; M G Patti; M Arcerito; C Feo; L Stewart; M DePinto; S Bhoyrul; S Rangel; D Tyrrell; Y Fujino; S J Mulvihill; L W Way Journal: J Am Coll Surg Date: 1998-04 Impact factor: 6.113
Authors: S J Spechler; E Lee; D Ahnen; R K Goyal; I Hirano; F Ramirez; J P Raufman; R Sampliner; T Schnell; S Sontag; Z R Vlahcevic; R Young; W Williford Journal: JAMA Date: 2001-05-09 Impact factor: 56.272
Authors: Jeremy R Huddy; Sheraz R Markar; Melody Z Ni; Mario Morino; Edoardo M Targarona; Giovanni Zaninotto; George B Hanna Journal: Surg Endosc Date: 2016-04-29 Impact factor: 4.584
Authors: Bernardo Borraez-Segura; Manuel Mena; Santiago Bedoya; Carlos Ramirez; Felipe Anduquia; Natalia Hurtado; Hugo Bedoya; Carlos Calvache Journal: Indian J Gastroenterol Date: 2019-10
Authors: A Aiolfi; M Cavalli; A Sozzi; F Lombardo; A Lanzaro; V Panizzo; G Bonitta; P Mendogni; P G Bruni; G Campanelli; D Bona Journal: Hernia Date: 2021-10-30 Impact factor: 2.920
Authors: S Kapoulas; A Papalois; G Papadakis; G Tsoulfas; E Christoforidis; B Papaziogas; D Schizas; G Chatzimavroudis Journal: Hernia Date: 2021-01-05 Impact factor: 4.739