Large hiatus hernia requiring hiatoplasty - An ongoing challenge: A case series

jpedsurg.org

Evidence for the management of large hiatus herniae (HH) in children is lacking. Adult literature is conflicting with regard to risk vs. benefit profile of prosthetic mesh use; rates of dysphagia or recurrence are up to 25 % and 38 %, respectively. We aimed to assess the efficacy of using a biological tissue matrix to augment hiatoplasty.

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Article · Aug 2025 · 1 min read

In brief

This case series examines surgical management of large hiatus herniae in pediatric patients using biological tissue matrix to reinforce hiatoplasty. The study addresses gaps in pediatric evidence and explores alternatives to prosthetic mesh, which carries significant complication rates in adults including dysphagia and recurrence.

Evidence for managing large hiatus hernias in pediatric patients is currently lacking, creating clinical uncertainty.
Adult studies show high complication rates: up to 25% dysphagia and 38% recurrence after hiatus hernia repair.
Biological tissue matrix may offer an alternative to prosthetic mesh for augmenting hiatoplasty in children.
Prosthetic mesh use in hiatus hernia repair has a conflicting risk-benefit profile in adult literature.
Recurrence and dysphagia remain significant challenges in large hiatus hernia surgical management.

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