OGBN O01 Laparoscopic large hiatus hernia repair with mesh versus suture: a systematic review and meta-analysis

Abstract Background Whilst the use of laparoscopy in repair large hiatus hernia (LHH) has become mainstream, prevention post operative recurrence and other adverse events remained a challenge. Mesh reinforcement suture cruroplasty been considered as potential solution. However paucity well constructed powered randomised control trials (RCT) with long term followup makes an assessment its real impact difficult. The aim this review is to evaluate effectiveness mesh LHH repair, regards postoperative outcomes. Methods A systematic search articles was conducted PubMed, Medline Embase using PRISMA guidelines. RCTs observational studies (OS) comparing recurrences reoperations those patients (>30% stomach chest, >5cm hiatal defect, surface area >10 mm2) who had vs no were assessed quantitatively. on significant intraoperative/postoperative surgical complications mortality qualitatively assessed. Results Pooled data included five fourteen OS 1670 (824 mesh, 846 mesh). There reduction total rate (OR 0.44, 95% CI 0.25 0.80, p = 0.007). did not cause >2cm 0.94, 0.52 1.67, 0.83) or reoperation rates 0.64, 0.39 1.07, 0.09). None meshes found significantly reduce subgroup analysis, although number single type limited. Major morbidity associated erosion foregut resection (from synthetic mesh) esophageal perforation 0.71% 0.36% respectively. An overall 0.3% pooled patients. Conclusions protective against recurrence. there (>2cm) rate. If be used need informed risk erosion.