2004, Número 1
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Rev Mex Cir Endoscop 2004; 5 (1)
Mallas en el hiato: Una controversia no solucionada
Targarona EM, Balaguém C, Garriga J, Trías M
Idioma: Español
Referencias bibliográficas: 113
Paginas: 44-57
Archivo PDF: 180.20 Kb.
RESUMEN
El éxito de la funduplicatura laparoscópica ha extendido el abordaje laparoscópico al tratamiento de situaciones técnicamente más difíciles, como las hernias de hiato paraesofágicas (HHPE) o mixtas. Los resultados han demostrado que la reparación laparoscópica es factible y segura. Sin embargo, varias series han demostrado una incidencia de recidivas de hasta el 42%, por lo que algunos autores recomiendan el uso de prótesis para reforzar el cierre hiatal.
Objetivo: El objetivo de esta revisión ha sido analizar la experiencia publicada en el uso de mallas para prevenir la recidiva después de la reparación laparoscópica de la HHPE.
Material y métodos: Revisión sistemática de la literatura, con relación a series y artículos de opinión sobre el uso de mallas para prevenir la recidiva en la reparación de la HHPE.
Resultados: La mayoría de los artículos son series cortas. Existen escasos estudios comparativos o aleatorizados, comparando el uso de mallas con el cierre convencional. Sin embargo, el uso de mallas previene la recidiva herniaria y se acompaña de un bajo índice de complicaciones.
Conclusiones: La información disponible permite concluir que el uso de mallas para la reparación hiatal es seguro y previene la recidiva. Sin embargo, la información sobre los resultados a largo plazo es escasa, y pueden presentarse complicaciones graves. Por ello es recomendable su uso selectivo basado en la experiencia clínica del cirujano.
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