The effectiveness of mesh reinforcement during laparoscopic hiatal hernia repair

Purpose. To analyze short-term and long-term results of surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease.Materials and methods. A retrospective analysis of short-term and long-term results of treatment of 98 patients for the period 2009-2016, who underwented surgical treatment of hiatal hernia with a hernia defect size 5 or more cm was performed. The first group included 69 patients underwent suture repair of hernia defect. The second group underwent mesh repair - 29 patients.Results. Intraoperative complications - 7 (10.1%) versus 2 (6.9%), postoperative complications - 6 (8.7%) versus 3 (10.4%), the duration of surgery - 141 ± 21.1 min versus 179 ± 28.4, duration of hospital stay - 6.7 ± 1.6 days versus 6.9 ± 1.8, postoperative dysphagia - 11 (15.9%) versus 6 (20.7%) were not noted. In 5 years after surgery, reccurence in the suture group were noted in 14 (20.3%) patients, in the mesh group - in 4 (13.8%) patients. The total GERD-HRQL questionnaire score was 6.4 ± 1.8 points in the suture repair group and 5.9 ± 2.1 points in the mesh group. 9 (13%) patients in the suture repair group and 5 (17.2%) in the mesh group evaluated their condition as unsatisfactorily.Conclusion. The analysis of long-term results in 5 years after the surgery showed the absence of benefit after using mesh reinforcement during laparoscopic repair of large hiatal hernias compared to usual suture cruroraphy both in recurrence rate and in assessing the quality of life.