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