Open AccessLong‐term results of antireflux surgery indicate the need for a randomized clinical trial
Author(s) -
Sandbu R.,
Khamis H.,
Gustavsson S.,
Haglund U.
Publication year - 2002
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1046/j.1365-2168.2002.01990.x
Subject(s) - medicine , randomized controlled trial , open surgery , laparoscopy , surgery , clinical trial , general surgery
Background: Well conducted, comparative trials of laparoscopic versus open antireflux surgery with an adequate patient enrolment are few and they do not demonstrate obvious advantages for the laparoscopic approach except for a marginal gain in shorter hospital stay. The aim of this study was to compare the effectiveness of laparoscopic and open procedures. Methods: Two unselected groups of 230 patients were identified through a register of all inpatient public care in Sweden. Outcomes of laparoscopic and open antireflux surgery were compared using a disease‐specific questionnaire 4 years after operation. Results: Failure and dissatisfaction were significantly more common in the laparoscopy group than among patients having conventional open surgery. Treatment failure rates were 29·0 and 14·6 per cent respectively ( P = 0·004). Dissatisfaction rates were 15·0 and 7·0 per cent respectively ( P = 0·005). There was no other questionnaire item for which the proportion of failures differed significantly between the two groups. Conclusion: This study does not support the presumption that laparoscopic antireflux surgery is to be preferred to the open procedure. It is strongly recommended that a randomized controlled trial be conducted. © 2002 British Journal of Surgery Society Ltd