Skip to main content
main-content

20.10.2015 | Ausgabe 7/2016

Surgical Endoscopy 7/2016

Long-term outcomes of cruroplasty reinforcement with composite versus biologic mesh for gastroesophageal reflux disease

Zeitschrift:
Surgical Endoscopy > Ausgabe 7/2016
Autoren:
Bin Wang, Wei Zhang, Cheng-xiang Shan, Sheng Liu, Zhi-guo Jiang, Ming Qiu
Wichtige Hinweise
Bin Wang and Wei Zhang have contributed equally to this work.

Abstract

Aim

The aim of this study was to evaluate the issue of improvement of disadvantages of different type meshes.

Methods

A retrospective analysis was performed on 101 gastroesophageal reflux disease patients who underwent reinforcement of crura with or without prosthetic mesh. Three types of mesh, 4-ply biologic small intestine submucosa (SIS, Surgisis®, since November 2010), 6-ply SIS (Biodesign™ Surgisis®, since March 2011), and composite synthetic mesh (Crurasoft®, since May 2010), were used. All patients were assigned to simple suture group (n = 35), 4-ply SIS group (n = 13), 6-ply Biodesign™ group (n = 26) or Crurasoft® group (n = 27). Postoperative follow-up was performed via clinical visit or phone call contact. Subjective assessment included dysphagia, patients’ symptomatic outcome judgment according to Visick and patients’ satisfaction. Objective evaluation included hiatal hernia recurrence according to upper endoscopy and barium contrast swallow. Follow-up was completed in 83 patients with a mean duration of 45 months (range 16–149 months).

Results

For the objective outcomes, although anatomic recurrence of hiatal hernia did not significantly differ between groups at 6 months postoperatively, long-term results showed a protective effect of mesh implantation on hernia recurrence (p = 0.047). For the subjective outcomes, the mesh group had a more significant improvement in Visick score (p = 0.020) compared to the simple suture group. Patient satisfaction was significantly higher in the mesh group (p = 0.014), and subgroup analysis showed a clear trend as follows: Crurasoft® ≈ Biodesign® > SIS®. A higher frequency of postoperative dysphagia was presented in the Crurasoft group compared with other two groups at 6 months postoperatively, but the difference was not significant over time (p = 0.227).

Conclusion

Mesh cruroplasty results in satisfactory symptom control with a low recurrence rate. 6-ply biologic mesh is promising with respect to the reduction in anatomic recurrences. Postoperative dysphagia does not occur commonly following mesh cruroplasty with PTFE/ePTFE mesh.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 7/2016

Surgical Endoscopy 7/2016 Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise