الفهرس 
Applied Anatomy of Lower Esophagus and Gastroesophageal Junction Antireflux MechanismsOnly 14 pages are availabe for public view
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Abstract
Background: The incidence of hiatal hernias increases with age. Approximately 55%-60% of individuals over the age of 50 have a hiatal hernia. However, only about 9% have symptoms, and it depends on the type and competency of the lower esophageal sphincter.
Aim of the Work: In our study, an objective observational study was made regarding post operative short term mesh related complications possible to develop in patients underwent hiatal repair of large hiatal hernia with mesh rienforcement.
Patients and Methods: An observational cohort (retrospective and prospective) study regarding the post operative mesh related complications in patients who underwent Large diaphragmatic hernia repair with mesh application. The study was conducted at Ain Shams University Hospitals, Al-Demerdash, Department of General surgery. Approval of the research ethics Committee of medicine and general surgery department at faculty of medicine, Ain Shams University as well as a written informed consent from all participants was obtained. The study was conducted over a period of six months, starting from date of approval of the protocol by the faculty and the university committee at 10/7/2021.
Results: Five patients (33.3%) complained about dysphagia postoperatively. In one case, the symptoms declined spontaneously within 6 months was grade 1. Another patient successfully underwent esophageal dilatation of a stenosis 2 months postoperatively was grade 2. Up to this date, two patients (13.3%) still report mild dysphagia but maintain normal body weight were grade 3. Three cases report persistent intra-abdominal discomfort without weight loss described as bloating. Two patients experienced heartburn, while another patient reported respiratory compromise in the form dyspnea due to already huge hiatal defect with lung collapse present preoperatively.
Conclusion: Laparoscopic large hiatal/paraesophageal hernia repair with prosthetic meshes as well as laparoscopic antireflux surgery with prosthetic hiatal closure are safe and effective procedures to prevent hiatal hernia recurrence and/or postoperative intrathoracic wrap migration, with low complication rates.