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首页> 外文期刊>Surgical Endoscopy >Mesh erosion following prosthetic hiatal closure.
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Mesh erosion following prosthetic hiatal closure.

机译：修复性裂孔后网孔侵蚀。

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摘要

We appreciate the interest of Dr. Vakili in our recently published study "Laparoscopic antireflux surgery: Tailoring the hiatal closure to the size of hiatal surface area" . The main objective of the article was to present a standardized technique of measuring the hiatal defect during laparoscopic antireflux surgery and large hiatal hernia repair and subsequently find an appropriate way to effectively close the hiatal defect. We are aware that the use of prosthetic materials for crural closure can lead to postoperative mesh-related complications such as mesh erosion or mesh migration into the distal esophagus or the stomach. Because of these complications, we must have a standardized technique for effectively closing the esophagealhiatus with low recurrence rates on the one hand and a minimization of mesh-related complications on the other hand. Like Dr. Vakili, we believe that the routine use of prosthetic meshes or pledgets for hiatal closure during laparoscopic antireflux procedures must be srutinized.Dr. Vakili also reported on two patients who returned with esophageal erosion from hiatal closure with polypropylene pledgets. A large number of studies show that there is a high recurrence rate in patients with large hiatal or paraesophagealhernias . An efficient closure of the hiatus often is impossible in these patients without the use of mesh. To strike a balance between these positions, the use of mesh should depend on the size of the hiatal defect .
机译：我们感谢瓦基里（Vakili）博士在我们最近发表的研究“腹腔镜抗反流外科手术：将裂孔闭合适应于裂孔表面积的大小”中的兴趣。本文的主要目的是提出一种在腹腔镜抗反流手术和大型裂孔疝修补术中测量裂孔缺损的标准化技术，并随后找到有效闭合裂孔缺损的合适方法。我们知道，使用人工材料进行闭合闭合可能导致术后与网孔相关的并发症，例如网孔侵蚀或网孔迁移到食道远端或胃中。由于这些并发症，我们必须有一种标准化的技术，一方面可以有效地关闭食管裂孔，但复发率低，另一方面可以最大程度地减少网状并发症的发生。像Vakili博士一样，我们认为必须严格遵守在腹腔镜抗反流手术期间常规使用义眼网或小孔封闭孔的做法。 Vakili还报道了两名患者因聚丙烯楔子封孔导致食管糜烂复发。大量研究表明，食管裂孔或食管旁疝大的患者复发率高。在不使用网片的情况下，这些患者通常无法有效地关闭裂孔。为了在这些位置之间取得平衡，网格的使用应取决于裂孔缺损的大小。

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