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Type: Journal article
Title: Prospective randomized trial of laparoscopic Nissen fundoplication with anterior versus posterior hiatal repair: Late outcomes
Author: Chew, C.
Jamieson, G.
Devitt, P.
Watson, D.
Citation: World Journal of Surgery, 2011; 35(9):2038-2044
Publisher: Springer
Issue Date: 2011
ISSN: 0364-2313
Statement of
Carolyn R. Chew, Glyn G. Jamieson, Peter G. Devitt, David I. Watson
Abstract: <h4>Background</h4>The technique used for hiatal closure in laparoscopic Nissen fundoplication might have an impact on the risk of postfundoplication dysphagia and hiatal herniation. In 1997, we commenced a randomized trial to evaluate the impact of anterior versus posterior hiatal repair techniques on these outcomes. In the present study, we evaluated the 10-year outcomes from this trial.<h4>Methods</h4>A total of 102 patients were randomized to undergo laparoscopic Nissen fundoplication with either anterior (47 patients) or posterior (55 patients) repair of the diaphragmatic hiatus. Outcomes were assessed using standardized clinical assessment scores that evaluated reflux symptoms, dysphagia, and satisfaction with the outcome following surgery.<h4>Results</h4>Clinical outcomes 10 years after surgery were available for 93% of patients, and outcome scores were obtained for 43 patients in each group. Patients undergoing anterior hiatal repair were less likely to report dysphagia for lumpy solid foods (14.0% vs. 39.5%, p = 0.01), although there were no significant differences in dysphagia outcomes for six other dysphagia assessment scores. There were no differences between the two groups for reflux symptoms, medication use, and overall satisfaction with the outcome of surgery.<h4>Conclusions</h4>At the 10-year follow-up, the outcomes for the two groups were similar. Anterior hiatal repair is an acceptable technique for hiatal closure during laparoscopic Nissen fundoplication.
Keywords: Humans
Gastroesophageal Reflux
Hernia, Hiatal
Postoperative Complications
Treatment Outcome
Severity of Illness Index
Statistics, Nonparametric
Follow-Up Studies
Prospective Studies
Middle Aged
Patient Satisfaction
Rights: © Société Internationale de Chirurgie 2011
DOI: 10.1007/s00268-011-1172-x
Appears in Collections:Aurora harvest
Surgery publications

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