On the question of choosing a method of plastic surgery of the esophageal opening in case of a hiatal hernia

Purpose of a study: to analyze the results of 20 years of experience in repair of hiatal hernias using various mesh implants in Clinic of Bashkir State Medical University (Ufa, Russia).

Material and methods. A retrospective study of the database of 1516 patients with hiatal hernias treated in the clinic in 2005–2024 was conducted, in whom its correction included hiatoplasty using a mesh implant. Mesh safety was assessed by recording complications associated with the use of the mesh. Hiatoplasty was considered indicated when the dilation of the esophageal opening was more than 3.5 cm. Perioperative morbidity, functional results and recurrence rate during follow-up, and overall patient satisfaction were analyzed.

Results. Diaphragmocurrography was performed in 268 (17.7%) cases, in 182 (12.0%) cases the esophageal opening of the diaphragm was replaced with a mesh implant, in total the esophageal opening was corrected in 450 (29.7%) patients. Detailed clinical and instrumental evaluation of the treatment results was performed in 182 patients with mesh esophageal opening replacement. There was no perioperative mortality. The outcome without postoperative complications was achieved in 94.5% of cases. The quality of life of patients after surgery was studied by comparing the results of the questionnaires (GERD-HRQL and SF-36 questionnaires) and special methods for studying the closure function of the cardia.

Conclusion. Our data indicate that correction of hiatal hernia using augmentation with a non-absorbable mesh implant is technically easy to implement and safe with low perioperative morbidity and acceptable rates of postoperative complications in the immediate and long-term follow-up periods.

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