Hiatal hernia repair with tension-free mesh or crural sutures alone in antireflux surgery. A 13-year follow-up of a randomized clinical trial.

JAMA Surg 2024; 159: 11-18. 

Around one third of the original trial cohort had follow-up after a mean of 13 years. Rates of recurrent hiatal hernia on radiological assessment were similar: 38 per cent mesh and 31 per cent suture repair, P=0.61. Dysphagia rates were higher with the mesh, P=0.01.  

Comment: Routine use of mesh is not supported.