Meta-analysis Of Suture Repair Versus Mesh Repair For Large Hiatal Hernia

Objective:Hiatal hernia contributes to the pathophysiology of gastroesophageal reflux disease(GERD).Surgical treatment has become a routine method for of hiatal hernia.The present meta-analysis aimed to evaluate the effectiveness and security of mesh versus suture repair of hiatus hernia.Methods: Pub Med,EMBASE and Cochran database search,find as contrast to traditional laparoscopic repair in December 2017,the patch repair in the treatment of large hiatal hernia clinical research,in accordance with the relevant standards for the retrieval of literature in and out,the main evaluation indexes for the recurrence rate,complication etc.The Cochran risk bias assessment was used to evaluate the inclusion literature.The relevant data were extracted and Rev Man5.3 was applied for statistical analysis.Results: A total of 10 studies,including 1,377 patients,were included in this meta-analysis based on inclusion and exclusion criteria.Analysis results showed that the combined analysis showed that the mesh repair group(OR 0.29;95%ci: 0.15--0.56,P = 0.0002)compared with traditional suture group,the recurrence rate of large hiatus hernia was significantly reduced.There was no significant difference between the two groups after postoperative complications(primary,secondary),dysphagia,and patient satisfaction scores.Conclusions: The mesh repair in reducing postoperative recurrence and postoperative reoperation rate in treatment of large hiatal hernia is superior to the traditional suture repair,but the more long-term effects remain to be more quality long-term randomized controlled trial to further clarify.There was no significant difference in the improvement of postoperative living conditions and the reduction of complications.