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Primary endpoint: hernia recurrence by barium meal radiology and endoscopy at 6 months; secondary endpoints: symptom scores through 12 months. Results and conclusions assess recurrence and symptom differences across groups.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/laparoscopic-repair-of-very-large-hiatus-hernia-a-randomized-controlled-trial/142425/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/laparoscopic-repair-of-very-large-hiatus-hernia-a-randomized-controlled-trial/142425.png","ImageObject",300,407,{"name":42,"@type":43},"Xiajie","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-17","2026-08-25",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What question did the randomized controlled trial address?","Question",{"text":63,"@type":64},"Whether absorbable or nonabsorbable mesh in repair of very large hiatus hernias reduces hernia recurrence compared with suture repair.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was hernia recurrence assessed in the study?",{"text":68,"@type":64},"Recurrence was assessed using barium meal radiology and endoscopy, with the primary evaluation at 6 months.",{"name":70,"@type":61,"acceptedAnswer":71},"Were there significant differences in recurrence and symptoms between repair methods?",{"text":72,"@type":64},"No significant differences were observed for recurrent hiatus hernia. Clinical symptom differences were small and unlikely to be clinically significant overall.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},142425,1787681003,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},7,"Healthcare",40,"healthcare",{"id":112,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":113,"slug":114},8,30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":112,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":112,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":80,"read_time":118,"preview_page_count":4},8814010472675,"https://avatar.qwps.com/avatar/WGlhamll","Laparoscopic Repair of Very Large Hiatus Hernia With Sutures Versus Absorbable Mesh Versus Nonabsorbable Mesh  \nA Randomized Controlled Trial  \nDavid I. Watson, MD, MBBS, FRACS, ∗ Sarah K. Thompson, MD, PhD, FRCSC, FRACS,† Peter G. Devitt, MS,† Lorelle Smith, BNurs, ∗† Simon D. Woods, MBBS, FRACS,‡ Ahmad Aly, MBBS, MS, FRACS,§  \nSusan Gan, MBBS, FRACS, ∗ Philip A. Game, MBBS, FRCS, FRACS,†  \nand Glyn G. Jamieson, MS, MBBS, FRCS, FACS, FRACS†  \nObjective: Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair.  \nBackground: Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. Previous trials have shown less short-term recurrence with mesh, but adverse outcomes limit mesh use.  \nMethods: Multicentre prospective double blind randomized controlled trial of 3 methods of repair: sutures versus absorbable mesh versus nonabsorbable mesh. Primary outcome—hernia recurrence assessed by barium meal radiology and endoscopy at 6 months. Secondary outcomes—clinical symptomscores at 1, 3, 6, and 12 months.  \nResults: A total of 126 patients enrolled: 43 sutures, 41 absorbable mesh, and 42 nonabsorbable mesh. Among them, 96.0% were followed up to 12 months, with objective follow-up data in 92.9%. A recurrent hernia (any size) was identified in 23.1% after suture repair, 30.8% after absorbable mesh, and 12.8% after nonabsorbable mesh (P = 0.161). Clinical outcomes were similar, except less heartburn at 3 and 6 months and less bloating at 12 months with nonabsorbable mesh; more heartburn at 3 months, odynophagia at 1 month, nausea at 3 and 12 months, wheezing at 6 months; and inability to belch at 12 months after absorbable mesh. The magnitudes ofthe clinical differences were small.  \nConclusions: No significant differences were seen for recurrent hiatus hernia, and the clinical differences were unlikely to be clinically significant. Overall outcomes after sutured repair were similar to mesh repair.  \nKeywords: hiatus hernia, laparoscopy, mesh repair, randomized controlled trial  \n(Ann Surg 2015;261:282–289)  \nL aparoscopic  \nlarge hiatus  \nsurgery for the treatment of patients with a very hernia is now standard clinical practice. This prob-  \nFrom the ∗Flinders Medical Centre, Department of Surgery, Flinders University, Bedford Park, South Australia, Australia; †Royal Adelaide Hospital, Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia;‡Cabrini Hospital, Malvern, Victoria, Australia; and §Department of Surgery, Austin Hospital, University of Melbourne, Heidelberg, Victoria, Australia.  \nDisclosure: This randomized trial was supported by Research Project Grants from the National Health and Medical Research Council (NHMRC) of Australia (Grant numbers 375111 and 1022722) . This trial is registered with the Australia and New Zealand Clinical Trials Registry ACTRN12605000725662 . The authors declare no conflicts of interest.  \nReprints: David I. Watson, MD, MBBS, FRACS, Flinders Medical Centre, Department of Surgery, Flinders University, Room 3D211, Bedford Park, South Australia 5042, Australia. E-mail: david.watson@fl[inders.edu.au](inders.edu.au).  \nCopyright  2014 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0003-4932/14/26102-0282  \nDOI: 10.1097/SLA.0000000000000842  \nlem occurs most commonly in elderly patients, and in the early days of laparoscopic antireflux surgery it represented less than 10% of the antireflux surgery and hiatus hernia repair workload.1 However, as laparoscopic techniques for repair have become more reliable, surgeons have been referred more patients with very large hiatus hernias, and in recent years the number of patients with this problem has increased greatly, now comprising approximately 50% of the laparoscopic antireflux surgery workload in our practices.1 In the 1990s, the standard approach to lap","cbCaial0C3MfxRZt","https://ap.wps.com/l/cbCaial0C3MfxRZt","pdf",184691,"English","# Objective\n# Background\n# Methods\n## Trial design\n## Outcomes\n# Results\n## Follow-up and recurrence\n## Clinical outcomes\n# Conclusions\n# Keywords","[{\"question\":\"What question did the randomized controlled trial address?\",\"answer\":\"Whether absorbable or nonabsorbable mesh in repair of very large hiatus hernias reduces hernia recurrence compared with suture repair.\"},{\"question\":\"How was hernia recurrence assessed in the study?\",\"answer\":\"Recurrence was assessed using barium meal radiology and endoscopy, with the primary evaluation at 6 months.\"},{\"question\":\"Were there significant differences in recurrence and symptoms between repair methods?\",\"answer\":\"No significant differences were observed for recurrent hiatus hernia. Clinical symptom differences were small and unlikely to be clinically significant overall.\"}]","Laparoscopic Repair of Very Large Hiatus Hernia - A Randomized Controlled Trial | PDF"]