Introduction Use of prosthetic mesh is advocated in giant hiatus hernia repair to reduce the chance of recurrence. However, complications related to the use of mesh at the oesophageal hiatus have been reported. Composite meshes have been developed which have a lower adhesive potential and may reduce complication rates. We report the outcome of a large case series of patients undergoing hiatus hernia repair using the composite Crurasoft® (BARD) mesh.
Methods A retrospective study was performed of all patients who had undergone primary or recurrent hiatus hernia repair using Crurasoft® (BARD) mesh in a single tertiary referral centre. Patient demographics, pre-operative investigations, operation and follow-up details were recorded.
Results Over a 6-year period 53 patients underwent laparoscopic hiatus hernia repair using Crurasoft® (BARD) mesh, of which 36 patients had a primary giant hiatus hernia repair. A concurrent anti-reflux procedure was performed in 44 patients. There were three conversions to open operation, two in patients undergoing primary repair due to difficulties reducing the stomach, and one in a patient undergoing surgery for recurrence due to adhesions. The median time for follow-up was 45 months (range 8–94). Significant complications included dysphagia in 12 (22.6%) patients, which was due to an oesophageal stricture in 2 (3.8%) patients. Mesh erosion into the oesophagus occurred in 2 (3.8%) patients, and 12 (22.6%) patients developed a symptomatic recurrence. Reoperation within 30 days of initial surgery was required in 5 (9.4%) patients and was due to an early recurrence in 3 (5.7%) patients. There were no mortalities.
Conclusion The composite Crurasoft® (BARD) mesh can successfully be used in giant hiatus hernia repair. However, this mesh does not prevent significant mesh related oesophageal complications and is associated with a high recurrence rate.
Competing interests None declared.
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