Overview
Patients scheduled for surgery for primary paraesophageal herniation are randomized to either conventional surgical hernia repair or with the addition of gastropexy.
Description
Patient undergoing surgery for primary paraesophageal herniation, are randomized to either the control group or interventional group. The control group have a crural repair alone to which is added a short and floppy Nissen fundoplication. The interventional arm contains the addition of a gastropexy which incorporates fixation of the left part of the wrap to the diaphragm as well as the posterior part to the right crus. Finally the minor curvature of the stomach is sutured left to the midline of the abdominal wall.
The patients are examined by computed tomography before surgery and at 1 and 3 years after surgery.
SF-36 (global quality of Life instrument), GSRS (Gastrointestinal Symptoms Rating Scale), Reflux frequency issues and Watson's dysphagia score are completed before and at 3 and 6 month as well as 1 and 3 years after surgery.
Eligibility
Inclusion Criteria:
- all patients with primary hiatus hernia type II-IV who are deemed suitable for surgery
Exclusion Criteria:
- American Society of Anesthesiologists physical status-system (ASA) >III
- inability to understand the nature of the purpose of the study and/or to give informed consent.
- Achalasia or another severe esophageal motor disorder
- Previous major upper GI surgery(including previous hiatal hernia repair)