title: Rectus abdominus fascial sheath usage for crural reinforcement during surgical management of GERD: preliminary report of a prospective randomized clinical trial.
abstract: OBJECTIVE
  Many materials are currently being used to reinforce the crural repair. Perforation, intensive fibrosis, and price are limiting the usage of these materials. Our purpose was to seek an alternative, cheap, always available, and inert material to use for cruroplasty reinforcement.
  
  
  METHODS
  Twenty-four patients participated and were randomly divided into 2 groups (graft+laparoscopic Nissen fundoplication and laparoscopic Nissen fundoplication alone) with 12 patients in each group. Total operation time, postoperative dysphagia rate, dysphagia improvement time, postoperative pain, recurrence, and incisional hernia rate were compared.
  
  
  RESULTS
  There was no difference in terms of study parameters between both groups except for the mean operation time.
  
  
  CONCLUSIONS
  Autograft hiatoplasty seems to be a good alternative for crural reinforcement. It provides safe reinforcement, has the same dysphagia rates as meshless hiatoplasty, and avoids potential complications of redo surgery by minimizing extensive fibrosis. Furthermore, the rectus abdominus sheath is always available and inexpensive.
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, Ankara, Turkey. yigittaner@gmail.com
authors.forename: Taner
authors.initials: T
authors.lastname: Yigit
authors.forename: Ali Kagan
authors.initials: AK
authors.lastname: Coskun
authors.forename: Huseyin
authors.initials: H
authors.lastname: Sinan
authors.forename: Ali
authors.initials: A
authors.lastname: Harlak
authors.forename: Murat
authors.initials: M
authors.lastname: Kantarcioglu
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kilbas
authors.forename: Orhan
authors.initials: O
authors.lastname: Kozak
authors.forename: Sadettin
authors.initials: S
authors.lastname: Cetiner
mesh_terms: D000328:Adult; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D017568:Rectus Abdominis / Q000637:transplantation*; D012008:Recurrence; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult