One-year outcomes of biological mesh in hiatal hernia repair: a real-world study.

Purpose: The placement of synthetic mesh during laparoscopic hiatal hernia repair has been verified to reduce postoperative recurrence, but mesh erosion and other related complications may occur to synthetic mesh, and our aim was to verify the safety and efficacy of biological mesh in hiatal hernia repair.

Methods: Patients with hiatal hernia who were treated at a tertiary teaching university hospital from December 2020 to May 2023 were prospectively included in this study. General clinical data, hernia-related data, and intraoperative data were collected, and the patients were followed up at 1, 3, 6, and 12 months after surgery, after 12 months, follow-up as needed for primary outcome until September 2024. The following parameters were recorded during follow-up visit: gastroesophageal reflux symptoms, Gastroesophageal reflux disease-Health related quality of life (GERD-HRQL) questionnaire, postoperative recurrence, mesh-related complications and patients' overall satisfaction.

Results: A total of 82 patients with hiatal hernia were included in this study. The mean age of the patients was 62.68 ± 15.93 years, mean BMI 24.81 ± 4.05 kg/m², the average operation time was 128.21 ± 39.20 min. There was statistically significant improvement of GERD symptom postoperative (p<0.05). 72 cases (93.5%) were rated as "Great" on the GERD-HRQL at the 12 months after surgery; 65 cases (84.4%) were rated as "very satisfactory" on the overall satisfaction scale at the 12 months after surgery. 6 patients (7.3%) experienced recurrences, with no mesh-related complications reported during the follow-up.

Conclusion: At a mean follow-up of 25.43 ± 10.38 months, the present study showed that laparoscopic hiatal hernia repair with biologic mesh results in low rates of 1-year recurrence and complications and increased patient satisfaction.