Different Biologic Grafts for Diaphragmatic Crura Reinforcement during Laparoscopic Repair of Large Hiatal Hernia: A 6-Year Single Surgeon Experience
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Abstract
Minimally invasive approach in the repair of hiatal hernias became
a standard of care during the last two decades. Laparoscopy offers
faster recovery, shorter hospital stay and less morbidity than traditional
laparotomy [1,2]. Several studies have shown higher recurrence rates
after a suture-based repair of hiatal hernias [3-5]. A “tension-free”
repair with prosthetic mesh allowed to decreased recurrence [6], but the
use of synthetic materials produced potentially serious problems, such
as erosion and dysphagia [7-10]. Multiple reports showed reduction
in short-term recurrence rate after hiatal hernia repair with biologic
grafts [11-15]. However, the improvement in hiatal hernia recurrence
decreased at long-term follow-up.
