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Title: Mesh-related complications in paraoesophageal repair: a systematic review.
Austin Authors: Spiro, Calista;Quarmby, Natalie;Gananadha, Siva
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Calvary Bruce Public Hospital, Bruce, ACT, Australia
The Canberra Hospital, Garran, ACT, Australia
Issue Date: Oct-2020 2020-06-18
Publication information: Surgical Endoscopy 2020; 34(10): 4257-4280
Abstract: Paraoesophageal hernias (PEH) have a high recurrence rate, prompting surgeons to consider the use of mesh reinforcement of the hiatus. The risks and benefits of mesh augmentation in PEH repair are debated. Mesh-related complications including migration and erosion are considered in this publication. A systematic literature review of articles published between 1970 and 2019 in Medline, OVID, Embase, and Springer database was conducted, identifying case reports, case series and observational studies of PEH repair reporting mesh-related complications. Thirty-five case reports/series of 74 patients and 20 observational studies reporting 75 of 4200 patients with mesh complications have been included. The incidence of mesh-related erosions in this study is 0.035%. PTFE, ePTFE, composite and synthetic meshes were frequently associated with mesh erosion requiring intervention. Complete erosions are often managed endoscopically while partial erosions may require surgery and resection of the oesophagus and/or stomach. Mesh-related complication is rare with dysphagia a common presenting feature. Mesh erosion is associated with synthetic mesh more frequently in the reported literature. A mesh registry with long-term longitudinal data would help in understanding the true incidence of mesh-related complications.
DOI: 10.1007/s00464-020-07723-0
ORCID: 0000-0002-3469-7390
PubMed URL: 32556700
Type: Journal Article
Subjects: Anti-reflux surgery
Biologic mesh
Hiatal hernia repair
Laparoscopic paraoesophageal hernia repair
Mesh erosion
Synthetic mesh
Appears in Collections:Journal articles

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