controversies in complex hiatal hernia peh_guerron.… · (gpeh) repair in patients with persistent...
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ControversiesinComplexHiatalHernia
A.DanielGuerrón MD
AssistantProfessorofSurgeryDepartmentofSurgery
DivisionofMetabolicandWeightLossSurgeryDukeUniversityHealthSystem
@danguerron
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Disclosure
• Gore• Levita• Medtronic
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ControversyAs always, when data are scarce, opinions are strongly held!
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n=108at4Institutions
57primaryrepair:51biologicmesh
PrimaryOutcomerecurrence(>2cm)byUGIat6months
93%followupand90%had6monthUGI
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operativetime- 183minprimary:202biologic
6monthrecurrence- 12primary:4biologic
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NoQualityoflifeDifference
RecurranceRate- 59%primary:54%biologicnostatisticdifference
Nostrictureserosions,dysphagiarelatedtobiologic