10 years of follow-up after surgery for hiatal hernia by tension-free mesh closure or simple suturing.
One-hundred and fifty-nine patients undergoing Nissen fundoplication for symptomatic gastro-oesophageal reflux disease (GORD), who had a concomitant hiatal hernia of \> 2 cm axial length, were previously randomized to closure of the diaphragmatic hiatus with either crural sutures alone or tension-free closure with a non-absorbable mesh. Primary outcome variable was the incidence of radiologically verified recurrent hiatal hernia 3 years after the surgery and secondary outcomes were dysphagia score, reflux control and quality of life. The study showed no differences between the groups regarding hiatal hernia recurrence but higher dysphagia scores for solid food at 3 years in mesh group. This study is a long-term follow-up (\>10 years) after surgery for hiatal hernia by tension-free mesh closure or simple suturing.
Study Type
OBSERVATIONAL
Enrollment
103
Hiatal hernia repair by simple suturing of the diaphragmatic
Hiatal hernia repair by tension-free mesh closure
Ersta Hospital
Stockholm, Sweden
Recurrent hiatal hernia
The incidence of radiologically verified recurrent hiatal hernia
Time frame: 10 years
Dysphagia
Dysphagia for liquids and solids were recorded within a four-graded scale stating the frequency of dysphagia episodes with an arbitrary (empirical) cut off for clinical significance. The same dysphagia scoring was also used in a previous rct, from the same institution, comparing different types of antireflux procedures in open surgery.
Time frame: 10 years
Gastrointestinal symptom rating scale (GSRS)
A validated questionnaire containing five dimensions of abdominal symptoms (gastroesophageal reflux, abdominal pain, indigestion, obstipation and diarrhea
Time frame: 10 years
Quality of Life, physical and mental score: SF-36
The Swedish version of the validated global Short Form -36 (SF-36) questionnaire was used and data are presented as physical and mental summary component scores (PCS and MCS, respectively)
Time frame: 10 years
Proton pump inhibitor (PPI)
Number of patients who report daily intake of PPI at the time of the follow up Use of PPI use of PPI
Time frame: 10 years
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