‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis
Summary: In laparoscopic ‘paraoesophageal hernia’ (POH) repair, non-absorbable suture materials have been used to close the crural defects. More recently, various types of prosthetic mesh have been utilized to repair the defect. We conducted a systematic review with meta-analysis of the recent and u...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-01-01
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| Series: | Asian Journal of Surgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958418302793 |
| _version_ | 1818036390884016128 |
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| author | Rajeev Sathasivam Gopinath Bussa Yirupaiahgari Viswanath Reece-Bolton Obuobi Talvinder Gill Anil Reddy Venkat Shanmugam Andy Gilliam Prem Thambi |
| author_facet | Rajeev Sathasivam Gopinath Bussa Yirupaiahgari Viswanath Reece-Bolton Obuobi Talvinder Gill Anil Reddy Venkat Shanmugam Andy Gilliam Prem Thambi |
| author_sort | Rajeev Sathasivam |
| collection | DOAJ |
| description | Summary: In laparoscopic ‘paraoesophageal hernia’ (POH) repair, non-absorbable suture materials have been used to close the crural defects. More recently, various types of prosthetic mesh have been utilized to repair the defect. We conducted a systematic review with meta-analysis of the recent and up to-date studies incorporating 942 POH repairs. We examined the rates of recurrence, reoperation, and complication rates alongside operative time of these two techniques in the management POH. Randomized controlled trials (RCT) and observational studies comparing mesh hiatal hernioplasty versus Suture cruroplasty for Paraoesophageal hernia were selected by searching Medline, Embase, and Cochrane Central database published between January 1995 and December 2016. Predefined inclusion and exclusion criteria were applied to select the studies. The outcome variables analysed are recurrence of hiatal hernia, reoperation, operative time and complications. Nine studies (RCTs = 4 and Observational studies = 5) were analysed totalling 942 patients (Mesh = 517, Suture cruroplasty = 425). The pooled effect size for recurrence favoured mesh repair over suture cruroplasty (OR 0.48, 95% CI 0.32, 0.73, P < 0.05). But the operation time is significantly less in suture cruroplasty (SMD 15.40, 95% CI 7.92, 22.88, P < 0.0001). Comparable effect sizes were noted for both groups which included reoperation (OR 0.35, 95%CI 0.09, 1.31, P = 0.12) and complication rates (OR 1.30, 95%CI 0.74, 2.29, P = 0.36). Our systematic review and meta-analysis demonstrates that mesh hiatoplasty and suture cruroplasty produce comparable results with regards to reoperation rate and complications following the repair of paraoesophageal hernias (POH). Moreover, the study showed significant reduction of recurrence following mesh hiatoplasty. Keywords: Paraoesophageal, Hiatus hernia, Laparoscopy, Mesh |
| first_indexed | 2024-12-10T07:10:12Z |
| format | Article |
| id | doaj.art-c318d656f81d4f709948f3ffc214a232 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-10T07:10:12Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-c318d656f81d4f709948f3ffc214a2322022-12-22T01:58:05ZengElsevierAsian Journal of Surgery1015-95842019-01-014215360‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysisRajeev Sathasivam0Gopinath Bussa1Yirupaiahgari Viswanath2Reece-Bolton Obuobi3Talvinder Gill4Anil Reddy5Venkat Shanmugam6Andy Gilliam7Prem Thambi8University Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomJames Cook University Hospital, Marton Road, Middlesbrough, Cleveland, TS43 BW, United Kingdom; Corresponding author. James Cook University Hospital, Marton Road, Middlesbrough, TS43 BW, Cleveland, United Kingdom.James Cook University Hospital, Marton Road, Middlesbrough, Cleveland, TS43 BW, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomUniversity Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE, United KingdomSummary: In laparoscopic ‘paraoesophageal hernia’ (POH) repair, non-absorbable suture materials have been used to close the crural defects. More recently, various types of prosthetic mesh have been utilized to repair the defect. We conducted a systematic review with meta-analysis of the recent and up to-date studies incorporating 942 POH repairs. We examined the rates of recurrence, reoperation, and complication rates alongside operative time of these two techniques in the management POH. Randomized controlled trials (RCT) and observational studies comparing mesh hiatal hernioplasty versus Suture cruroplasty for Paraoesophageal hernia were selected by searching Medline, Embase, and Cochrane Central database published between January 1995 and December 2016. Predefined inclusion and exclusion criteria were applied to select the studies. The outcome variables analysed are recurrence of hiatal hernia, reoperation, operative time and complications. Nine studies (RCTs = 4 and Observational studies = 5) were analysed totalling 942 patients (Mesh = 517, Suture cruroplasty = 425). The pooled effect size for recurrence favoured mesh repair over suture cruroplasty (OR 0.48, 95% CI 0.32, 0.73, P < 0.05). But the operation time is significantly less in suture cruroplasty (SMD 15.40, 95% CI 7.92, 22.88, P < 0.0001). Comparable effect sizes were noted for both groups which included reoperation (OR 0.35, 95%CI 0.09, 1.31, P = 0.12) and complication rates (OR 1.30, 95%CI 0.74, 2.29, P = 0.36). Our systematic review and meta-analysis demonstrates that mesh hiatoplasty and suture cruroplasty produce comparable results with regards to reoperation rate and complications following the repair of paraoesophageal hernias (POH). Moreover, the study showed significant reduction of recurrence following mesh hiatoplasty. Keywords: Paraoesophageal, Hiatus hernia, Laparoscopy, Meshhttp://www.sciencedirect.com/science/article/pii/S1015958418302793 |
| spellingShingle | Rajeev Sathasivam Gopinath Bussa Yirupaiahgari Viswanath Reece-Bolton Obuobi Talvinder Gill Anil Reddy Venkat Shanmugam Andy Gilliam Prem Thambi ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis Asian Journal of Surgery |
| title | ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis |
| title_full | ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis |
| title_fullStr | ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis |
| title_full_unstemmed | ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis |
| title_short | ‘Mesh hiatal hernioplasty’ versus ‘suture cruroplasty’ in laparoscopic para-oesophageal hernia surgery; a systematic review and meta-analysis |
| title_sort | mesh hiatal hernioplasty versus suture cruroplasty in laparoscopic para oesophageal hernia surgery a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1015958418302793 |
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