Are esophagocrural sutures needed during laparoscopic fundoplication: A prospective randomized trial
Topic overview
Randomized trial of 106 pediatric patients found that omitting esophagocrural sutures during laparoscopic fundoplication with minimal esophageal dissection resulted in no wrap herniations and reduced operative time by 20 minutes. Results support simplified technique without compromising safety or reflux control at 4-year follow-up.
Key takeaways
- Esophagocrural sutures are unnecessary during fundoplication when minimal phrenoesophageal dissection is performed
- Omitting EC sutures reduces operative time by 20 minutes without increasing wrap herniation risk
- No wrap herniations occurred in either group at median 4-year follow-up, validating minimal dissection approach
- Reflux symptoms and medication use were equivalent with or without EC sutures at all follow-up timepoints
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