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A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication

BACKGROUND: Laparoscopic cruroplasty and fundoplication have become the gold standard in the treatment of hiatal hernia and gastro-oesophageal reflux disease (GERD). The use of a mesh-reinforcement of the cruroplasty has been proven effective; although, there is a lack of evidence considering which...

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Autores principales: Castelijns, P. S. S., Ponten, J. E. H., van de Poll, M. C. G., Nienhuijs, S. W., Smulders, J. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869985/
https://www.ncbi.nlm.nih.gov/pubmed/28928334
http://dx.doi.org/10.4103/jmas.JMAS_91_17
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author Castelijns, P. S. S.
Ponten, J. E. H.
van de Poll, M. C. G.
Nienhuijs, S. W.
Smulders, J. F.
author_facet Castelijns, P. S. S.
Ponten, J. E. H.
van de Poll, M. C. G.
Nienhuijs, S. W.
Smulders, J. F.
author_sort Castelijns, P. S. S.
collection PubMed
description BACKGROUND: Laparoscopic cruroplasty and fundoplication have become the gold standard in the treatment of hiatal hernia and gastro-oesophageal reflux disease (GERD). The use of a mesh-reinforcement of the cruroplasty has been proven effective; although, there is a lack of evidence considering which type of mesh is superior. The aim of this study was to compare recurrence rates after mesh reinforced cruroplasty using biological versus synthetic meshes. METHODS: We performed a systematic review of all clinical trials published between January 2004 and September 2015 describing the application of a mesh in the hiatal hernia repair during Nissen fundoplication for both GERD and hiatal hernia. The primary outcome was the recurrence rate, and secondary outcomes were complication rate, mortality and symptomatic outcome. RESULTS: We included 16 studies and extracted data regarding 1089 mesh operated patients of whom 385 received a biological mesh and 704 a synthetic mesh. The mean follow-up was 53.4 months. The recurrence rate in the synthetic mesh group was 6.8% compared to 16.1% in the biological mesh group (P < 0.05). The complication rate was 5.1% and 4.6% (P = 0.694), respectively, and there were 12 mesh-related complications. No mesh-related mortality was reported. CONCLUSION: Mesh reinforcement of hiatal hernia repair seems safe in the short-term follow-up. The available literature suggests no clear advantage of biological over synthetic meshes. Regarding cost-efficiency and short-term results, the use of synthetic nonabsorbable meshes might be advocated.
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spelling pubmed-58699852018-04-05 A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication Castelijns, P. S. S. Ponten, J. E. H. van de Poll, M. C. G. Nienhuijs, S. W. Smulders, J. F. J Minim Access Surg Review Article BACKGROUND: Laparoscopic cruroplasty and fundoplication have become the gold standard in the treatment of hiatal hernia and gastro-oesophageal reflux disease (GERD). The use of a mesh-reinforcement of the cruroplasty has been proven effective; although, there is a lack of evidence considering which type of mesh is superior. The aim of this study was to compare recurrence rates after mesh reinforced cruroplasty using biological versus synthetic meshes. METHODS: We performed a systematic review of all clinical trials published between January 2004 and September 2015 describing the application of a mesh in the hiatal hernia repair during Nissen fundoplication for both GERD and hiatal hernia. The primary outcome was the recurrence rate, and secondary outcomes were complication rate, mortality and symptomatic outcome. RESULTS: We included 16 studies and extracted data regarding 1089 mesh operated patients of whom 385 received a biological mesh and 704 a synthetic mesh. The mean follow-up was 53.4 months. The recurrence rate in the synthetic mesh group was 6.8% compared to 16.1% in the biological mesh group (P < 0.05). The complication rate was 5.1% and 4.6% (P = 0.694), respectively, and there were 12 mesh-related complications. No mesh-related mortality was reported. CONCLUSION: Mesh reinforcement of hiatal hernia repair seems safe in the short-term follow-up. The available literature suggests no clear advantage of biological over synthetic meshes. Regarding cost-efficiency and short-term results, the use of synthetic nonabsorbable meshes might be advocated. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5869985/ /pubmed/28928334 http://dx.doi.org/10.4103/jmas.JMAS_91_17 Text en Copyright: © 2017 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Review Article
Castelijns, P. S. S.
Ponten, J. E. H.
van de Poll, M. C. G.
Nienhuijs, S. W.
Smulders, J. F.
A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title_full A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title_fullStr A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title_full_unstemmed A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title_short A collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic Nissen fundoplication
title_sort collective review of biological versus synthetic mesh-reinforced cruroplasty during laparoscopic nissen fundoplication
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869985/
https://www.ncbi.nlm.nih.gov/pubmed/28928334
http://dx.doi.org/10.4103/jmas.JMAS_91_17
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