Publication:

Impact of mesh use in paraesophageal hernia repair: a review of short- and long-term outcomes

This review examines the role of mesh reinforcement in laparoscopic paraesophageal hernia repair (PEHR) by evaluating existing evidence on short-term and long-term outcomes. An extensive analysis of randomized controlled trials, cohort studies, and meta-analyses reveals that mesh use does not significantly impact perioperative morbidity, mortality, or immediate postoperative complications compared to primary suture repair. Additionally, long-term follow-up data show no substantial reduction in hernia recurrence or improvement in quality of life with mesh reinforcement. Although non-absorbable meshes are associated with a higher risk of mesh-related complications, biologic and biosynthetic meshes demonstrate fewer adverse events. Current evidence supports a selective use of mesh in high-risk or redo repairs rather than routine application. These findings underscore the importance of individualized patient assessment and careful consideration of the potential risks and benefits when deciding on mesh reinforcement in PEHR.