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Laparoscopic Nissen Versus Toupet Fundoplication for Hiatal Hernia.

17. juli 2026 oppdatert av: Katya Todorova, Sofia Med Hospital

Laparoscopic Nissen Versus Toupet Fundoplication for Gastroesophageal Reflux Management in Patients With Hiatal Hernia: A Patient- and Assessor-Blinded Randomized Controlled Trial

This randomized controlled trial compares laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication in patients undergoing surgical treatment for hiatal hernia associated with gastroesophageal reflux disease. Participants will be randomly assigned to one of two surgical groups. The study will evaluate postoperative pain, health-related quality of life, hospital stay, recurrence of reflux symptoms, gas-bloat symptoms, operative time, fundoplication time, and postoperative complications.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

200

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Bulgaria
    • Sofia-Grad
      • Sofia, Sofia-Grad, Bulgaria, 1517
        • Rekruttering
        • UMHAT Sofiamed
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Teodor D Atanasov, Assoc. prof.
        • Hovedetterforsker:
          • Katya T Todorova
        • Underetterforsker:
          • Alexander I Tsvetanov

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Patients aged 18 to 90 years
  • Patients diagnosed with primary hiatal hernia by fibrogastroscopy and/or barium swallow examination
  • Patients with symptoms of gastroesophageal reflux disease
  • Patients scheduled for elective laparoscopic hiatal hernia repair with fundoplication
  • Patients able to provide informed consent

Exclusion Criteria:

Patients younger than 18 years or older than 90 years Patients with recurrent hiatal hernia Patients who are not suitable for general anesthesia Patients who prefer a surgical approach other than laparoscopic surgery Patients who are unable or unwilling to provide informed consent

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Nissen fundoplication
Participants assigned to this arm will undergo laparoscopic hiatal hernia repair with Nissen fundoplication. The procedure includes a complete 360° fundoplication performed as part of standard laparoscopic antireflux surgery.
Fremgangsmåte: Laparoscopic Nissen Fundoplication
The procedure includes a complete 360° fundoplication performed as part of standard laparoscopic antireflux surgery.
Aktiv komparator: Toupet Fundoplication
Participants assigned to this arm will undergo laparoscopic hiatal hernia repair with Toupet fundoplication. The procedure includes a partial posterior 270° fundoplication performed as part of standard laparoscopic antireflux surgery.
Fremgangsmåte: Laparoscopic Toupet Fundoplication
The procedure includes a partial posterior 270° fundoplication performed as part of standard laparoscopic antireflux surgery.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Postoperative pain score at 24 hours
Tidsramme: 24 hours after surgery
Postoperative pain will be assessed 24 hours after surgery using the Visual Analog Scale. The score will be used to compare early postoperative pain between participants undergoing laparoscopic Nissen fundoplication and those undergoing laparoscopic Toupet fundoplication.
24 hours after surgery
Postoperative Pain Score at 7 Days
Tidsramme: 7 days after surgery
Postoperative pain will be assessed 7 days after surgery using the Visual Analog Scale. The score will be used to evaluate and compare short-term postoperative pain between the two intervention groups.
7 days after surgery
Change in Health-Related Quality of Life After Surgery
Tidsramme: Preoperatively, 1 week, 4 weeks
Health-related quality of life will be assessed using the GERD-Health Related Quality of Life questionnaire. Preoperative scores will be compared with postoperative scores in order to evaluate changes in reflux-related symptoms and quality of life after laparoscopic Nissen or Toupet fundoplication.
Preoperatively, 1 week, 4 weeks
Postoperative Hospital Stay
Tidsramme: From the day of surgery until hospital discharge - up to 30days
Postoperative hospital stay will be measured as the number of days from the day of surgery until hospital discharge. The duration of hospital stay will be compared between the Nissen and Toupet fundoplication groups.
From the day of surgery until hospital discharge - up to 30days
Recurrence of Gastroesophageal Reflux Symptoms
Tidsramme: 4 weeks and 1 year after surgery
Recurrence of gastroesophageal reflux symptoms will be assessed during postoperative follow-up. The presence or absence of recurrent reflux symptoms will be recorded and compared between the two intervention groups.
4 weeks and 1 year after surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Operative Timе
Tidsramme: Intraoperative
Operative time will be measured in minutes from the beginning to the end of the laparoscopic surgical procedure. Total operative time will be compared between participants undergoing Nissen fundoplication and those undergoing Toupet fundoplication.
Intraoperative
Fundoplication Time
Tidsramme: Intraoperative
Fundoplication time will be measured in minutes as the time required to perform the fundoplication component of the procedure. This measure will be used to compare the technical duration of Nissen and Toupet fundoplication.
Intraoperative
Gas-Bloat Symptoms
Tidsramme: 3 days; 1 week
Postoperative gas-bloat symptoms will be assessed during follow-up. The presence or absence of symptoms such as bloating, inability to belch, or increased abdominal gas-related discomfort will be recorded and compared between the two groups.
3 days; 1 week
Postoperative Complications
Tidsramme: Up to 30 days after surgery
Postoperative complications will be recorded according to type and frequency. The number and nature of postoperative complications will be compared between the Nissen and Toupet fundoplication groups.
Up to 30 days after surgery

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Sofia Med Hospital

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

29. mai 2023

Primær fullføring (Antatt)

30. juli 2026

Studiet fullført (Antatt)

31. januar 2027

Datoer for studieregistrering

Først innsendt

19. juni 2026

Først innsendt som oppfylte QC-kriteriene

17. juli 2026

Først lagt ut (Faktiske)

22. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

22. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

17. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 25/2023

Plan for individuelle deltakerdata (IPD)

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NEI

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