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Bitner et al. Mini-invasive Surg 2022;6:46 https://dx.doi.org/10.20517/2574-1225.2022.46 Page 3 of 6

Table 1. Metanalyses on mesh use in HHR in reverse chronological order
Hernia recurrence in index Need for Symptomatic Overall
procedure reoperation improvement complication
Authors RCT Obs n Favored Favored Favored Favored
Angeramo et al. 7 0 735 Neither Neither --- Suture
[13]
(2022)
Petric et al. (2022) [14] 7 0 735 Neither --- Neither Neither
[15]
Rausa et al. (2021) 8 9 1857 Mesh --- --- Neither
Campos et al. 6 2 520 Neither Neither --- Neither
[16]
(2020)
Memon et al. 5 0 478 Neither Mesh --- Neither
[17]
(2019)
Sathasivam et al. 4 5 942 Mesh Neither --- Neither
(2019) [18]
[19]
Zhang et al. (2017) 4 9 1474 Mesh --- Mesh Neither
Memon et al. 4 0 406 Neither Mesh --- Neither
[20]
(2016)
Tam et al. (2016) [21] 3 10 1194 Mesh Neither --- ---
[22]
Huddy et al.(2016) 4 5 676 Mesh Mesh --- Neither
Antoniou et al. 2 3 295 Mesh --- --- ---
[23]
(2015)
Muller-Stitch et al. 3 9 915 Neither --- --- Mesh
[24]
(2015)
Antoniou et al. 3 0 267 Mesh --- --- ---
(2012) [25]
Ellipsis indicates that meta-analysis was not carried out for this metric. RCT: Randomized controlled trials; HHR: hiatal hernia repair; Obs:
observational study.

Table 2. RCTs evaluating mesh vs. suture in HHR, in reverse chronological order
Follow- Overall Overall
Authors n Mesh Recurrence Reoperation
up satisfaction complication
Watson 126 5 years SIS (absorbable) or polypropylene Neither Neither --- ---
et al. (2020) [26] (non-absorbable)
Analatos 159 3 years PTFE (non-absorbable) Neither Neither Neither Neither
et al. (2020) [27]
Ilyashenko et al. 98 4.5 years Polyester-polylactic composite Mesh Mesh Neither Neither
(2018) [28] (non-absorbable)
[29]
Oor (2018) 72 1 year polypropylene (non-absorbable) Neither Neither Neither Neither
Oelschlager et al. 72 58 SIS (absorbable) Neither Neither Neither Neither
[30]
(2011) months
Granderath et al. 100 1 year polypropylene (non-absorbable) Mesh Neither Neither Neither
[31]
(2005)
Frantzides et al. 72 2.5 years PTFE (non-absorbable) Mesh --- Neither Mesh
[32]
(2002)
Ellipsis indicates that study did not compare this metric quantitatively. RCT: Randomized controlled trials; HHR: hiatal hernia repair.

repair .
[34]
Other considerations in anti-reflux surgery
Gastroesophageal reflux disease without HH
In general, although when considering mesh usage in ARS one is discussing HHR, mesh can be used in
non-HH-related ARS. In the only (small, n = 50) RCT to our knowledge in non-HH-related ARS comparing
mesh- to non-mesh repairs, Muller-Stich et al. compared laparoscopic mesh-augmented hiatoplasty with