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Inicio Cirugía Española Mallas en el hiato: una controversia no solucionada
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Vol. 75. Núm. 3.
Páginas 105-116 (marzo 2004)
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Vol. 75. Núm. 3.
Páginas 105-116 (marzo 2004)
Acceso a texto completo
Mallas en el hiato: una controversia no solucionada
Mesh repair of hiatal hernia: An ongoing controversy
Visitas
13925
Eduardo M. Targarona1
Autor para correspondencia
etargarona@hsp.santpau.es

Correspondencia: Servicio de Cirugía. Hospital de Sant Pau. Padre Claret, 167. 08025 Barcelona. España. Correo electrónico:
, Gali Bendahan, Carmen Carmen, Jordi Garriga, Manuel Trias
Servicio de Cirugía. Hospital de Sant Pau. Universidad Autónoma de Barcelona. Barcelona. España.
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Resumen

El éxito de la funduplicatura laparoscópica ha extendidoel abordaje laparoscópico al tratamiento delas hernias de hiato paraesofágicas o mixtas. Los resultadosdemuestran que la reparación es factible ysegura, aunque con una incidencia de recidivas elevada,por lo que algunos autores recomiendan el usode prótesis para reforzar el cierre hiatal. El objetivode esta revisión ha sido analizar la experiencia publicadacon el uso de mallas para prevenir la recidivadespués de la reparación laparoscópica de la herniade hiato paraesofágica. Existen escasos estudioscomparativos o aleatorizados en los que se compareel uso de mallas con el cierre convencional. Sin embargo,el uso de mallas previene la recidiva herniariay se acompaña de un bajo índice de complicaciones.La información disponible permite concluir que eluso de mallas para la reparación hiatal es seguro ypreviene la recidiva. Sin embargo, la información sobrelos resultados a largo plazo es escasa, y puedenpresentarse complicaciones graves. Por ello, es recomendablesu uso selectivo basado en la experienciaclínica del cirujano.

Palabras clave:
Hernia de hiato paraesofásica
Recidiva
Malla
Tratamiento

The success of laparoscopic funduplication has increasedthe use of the laparoscopic approach in thetreatment of paraesophageal or mixed hiatal hernia.The results show that laparoscopic repair is feasibleand safe, although the incidence of recurrence ishigh and consequently some authors recommend theuse of mesh to reinforce the hiatal closure. The presentreview aims to analyze published experience onthe use of mesh to prevent recurrence after laparoscopicrepair of paraesophageal hiatal hernias. Thereare few comparative or randomized studies comparingthe use of mesh with conventional closure.However, the use of mesh prevents hernia recurrenceand has a low complication rate. The informationavailable allows us to conclude that the use of meshin hiatal hernia repair is safe and prevents recurrence.However, information on the long-term results isscarce and severe complications can occur.Consequently, the selective use of mesh, based onthe surgeon’s clinical experience, is recommended.

Key words:
Paraesophageal hiatal
Recurrence
Mesh
Laparoscopic treatment
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