Document Detail


A prospective, randomized trial of laparoscopic polytetrafluoroethylene (PTFE) patch repair vs simple cruroplasty for large hiatal hernia.
MedLine Citation:
PMID:  12049534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Large hiatal hernias are prone to disruption, resulting in reherniation, when repaired with simple cruroplasty. The use of mesh may decrease the rate of reherniation in the laparoscopic repair of large hiatal hernias. DESIGN: Prospective, randomized controlled trial. SETTING: University-affiliated private hospital. PATIENTS: Seventy-two individuals undergoing laparoscopic Nissen fundoplication with a hernia defect greater or equal to 8 cm in diameter. INTERVENTION: Nissen fundoplication with posterior cruroplasty (n = 36) vs Nissen fundoplication with posterior cruroplasty and onlay of polytetrafluoroethylene (PTFE) mesh (n = 36). MAIN OUTCOME MEASURES: Recurrences, complications, hospital stay, operative time, and cost. RESULTS: Patients in both groups had similar hospital stays, but the PTFE group had a longer operative time. The cost of the repair was $960 +/- $70 more in the group with the prosthesis. Complications were minor and similar in both groups. There were 8 hernia recurrences (22%) in the primary repair group and none in the PTFE group (P<.006). CONCLUSION: The use of prosthetic reinforcement of cruroplasty in large hiatal hernias may prevent hernia recurrences.
Authors:
Constantine T Frantzides; Atul K Madan; Mark A Carlson; George P Stavropoulos
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  137     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-06     Completed Date:  2002-07-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Rush University, Chicago, IL, USA. Constantine_T_Frantzides@rush.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Fundoplication*
Hernia, Hiatal / surgery*
Humans
Laparoscopy*
Middle Aged
Polytetrafluoroethylene / therapeutic use
Prospective Studies
Prostheses and Implants
Recurrence / prevention & control
Surgical Mesh*
Grant Support
ID/Acronym/Agency:
1 K08 GM00703-01A1/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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