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- Analatos, ApostolosKarolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Stockholm, Sweden; Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Nyköping Hosp, Dept Surg, Nyköping, Sweden,Ersta Hosp, Dept Surg, POB 4619, SE-11691 Stockholm, Sweden.;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Danderyd, Sweden. (författare)
Tension-free mesh versus suture-alone cruroplasty in antireflux surgery : a randomized, double-blind clinical trial
- Artikel/kapitelEngelska2020
Förlag, utgivningsår, omfång ...
- John Wiley & Sons,2020
- printrdacarrier
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- LIBRIS-ID:oai:DiVA.org:uu-426366
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-426366URI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:144696994URI
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- Språk:engelska
- Sammanfattning på:engelska
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- BackgroundAntireflux surgery is effective for the treatment of gastro-oesophageal reflux disease (GORD) but recurrence of hiatal hernia remains a challenge. In other types of hernia repair, use of mesh is associated with reduced recurrence rates. The aim of this study was to compare the use of mesh versus sutures alone for the repair of hiatal hernia in laparoscopic antireflux surgery.MethodsPatients undergoing laparoscopic Nissen fundoplication for GORD between January 2006 and December 2010 were allocated randomly to closure of the diaphragmatic hiatus with crural sutures or non-absorbable polytetrafluoroethylene mesh (CruraSoft®). The primary outcome was recurrence of hiatal hernia, as determined by barium swallow study 12 months after surgery. Secondary outcomes were: intraoperative and postoperative complications, use of antireflux medication, postoperative oesophageal acid exposure, quality of life, dysphagia and duration of hospital stay.ResultsSome 77 patients were randomized to the suture technique and 82 patients underwent mesh repair. At 1 year, the hiatal hernia had recurred in six of 64 patients (9 per cent) in the mesh group and two of 64 (3 per cent) in the suture group (P = 0·144). Reflux symptoms, use of proton pump inhibitors and oesophageal acid exposure did not differ between the groups. At 3 years, recurrence rates were 13 and 10 per cent in the mesh and suture groups respectively (P = 0·692). Dysphagia scores decreased in both groups, but more patients had dysphagia for solid food after mesh closure (P = 0·013). Quality-of-life scores were comparable between the groups.ConclusionTension-free crural repair with non-absorbable mesh does not reduce the incidence of recurrent hiatal hernia compared with use of sutures alone in patients undergoing laparoscopic fundoplication. NCT03730233 (http://www.clinicaltrials.gov).
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- Håkanson, B. S.Karolinska Institutet,Ersta Hosp, Dept Surg, POB 4619, SE-11691 Stockholm, Sweden.;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Danderyd, Sweden. (författare)
- Lundell, L.Karolinska Institutet,Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden.;Odense Univ Hosp, Dept Surg, Odense, Denmark. (författare)
- Lindblad, M.Karolinska Institutet,Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden. (författare)
- Thorell, A.Ersta Hosp, Dept Surg, POB 4619, SE-11691 Stockholm, Sweden.;Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Danderyd, Sweden. (författare)
- Uppsala universitetCentrum för klinisk forskning i Sörmland (CKFD) (creator_code:org_t)
Sammanhörande titlar
- Ingår i:British Journal of Surgery: John Wiley & Sons107:13, s. 1731-17400007-13231365-2168
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- British Journal of Surgery (Sök värdpublikationen i LIBRIS)
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