BACKGROUND Laparoscopic large para-oesophageal hiatal hernia (LPHH) repair using mesh reinforcement significantly reduces postoperative recurrence rates compared to conventional suture repair, especially within short follow-up times. However, the ideal strategy for repairing LPHH remains disputable because no clear guidelines are given regarding indications, mesh type, shape or position. The aim of this study was to survey our short-term results of LPHH management with a biosynthetic monofilament polypropylene mesh coated with titanium dioxide to enhance biocompatibility (TiO2Mesh™). METHODS A retrospective study was performed at Ramon y Cajal University Hospital, Spain from December 2014 to October 2018. Data were collected on 27 consecutive patients with extensive hiatal hernia defects greater than 5 cm for which a laparoscopic repair was performed by primary suture and additional reinforcement with a TiO2Mesh™. Study outcomes were investigated, including clinical and radiological recurrences, dysphagia and mesh-related drawbacks. RESULTS Twenty-seven patients were included in our analysis; 10 patients were male, and 17 were female. The mean age was 73 years (range, 63-79 years). All operations were performed laparoscopically. The median postoperative hospital stay was 3 days. After a mean follow-up of 18 months (range, 8-29 months), only 3 patients developed clinical recurrence of reflux symptoms (11%), and 2 had radiological recurrences (7%). No mesh-related complications occurred. CONCLUSIONS TiO2Mesh™ was found to be safe for laparoscopic repair of LPHH with a fairly low recurrence rate in this short-term study. Long-term studies conducted over a period of years with large sample sizes will be essential for confirming whether this mesh is suitable as a standard method of care with few drawbacks.

中文翻译：

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腹腔镜修复大食管旁裂孔疝的TiO2滤网短期疗效评估。

背景技术与传统的缝合线修复相比，使用网状加固的腹腔镜大食管旁裂孔疝（LPHH）修复显着降低了术后复发率，尤其是在较短的随访时间内。但是，修复LPHH的理想策略仍然存在争议，因为没有给出关于适应症，网状类型，形状或位置的明确指导原则。这项研究的目的是调查使用涂有二氧化钛以增强生物相容性（TiO2Mesh™）的生物合成单丝聚丙烯筛网进行LPHH管理的短期结果。方法回顾性研究于2014年12月至2018年10月在西班牙拉蒙·卡哈尔大学医院进行。连续收集了27例裂孔性疝大于5 cm的广泛缺损患者的数据，通过初次缝合进行腹腔镜修复，并用TiO2Mesh™进行额外的加固。对研究结果进行了调查，包括临床和放射学复发，吞咽困难和网状相关缺陷。结果我们的分析中包括了27例患者。男性10例，女性17例。平均年龄为73岁（范围为63-79岁）。所有手术均在腹腔镜下进行。术后中位住院时间为3天。在平均随访18个月（8-29个月）后，仅3例出现了反流症状的临床复发（11％），而2例放射学复发（7％）。没有发生网状并发症。结论在此短期研究中，发现TiO2Mesh™对于腹腔镜LPHH修复是安全的，复发率相当低。多年来对大样本量进行的长期研究对于确认该筛网是否适合作为几乎没有缺点的标准护理方法至关重要。