Nykoping

Researchers are evaluating the effectiveness of adding gastropexy to conventional surgical repair for patients with primary paraesophageal hernias. This randomized, triple-blind clinical trial compares standard crural repair combined with a Nissen fundoplication against the same procedure with an additional three-point gastropexy. The study aims to determine if the gastropexy improves outcomes in hernia repair. Participants are divided into two groups the control group receives standard paraesophageal hernia repair, which includes crural suturing and a total Nissen fundoplication. The interventional group receives the same standard repair plus a gastropexy, which involves fixing parts of the stomach wrap to the diaphragm and abdominal wall using sutures. The study includes preoperative and postoperative imaging with CT scans at baseline, 1 year, and 3 years after surgery to assess anatomical results. Participants will complete several questionnaires before surgery and at 3 months, 1 year, and 3 years post-surgery to assess quality of life, gastrointestinal symptoms, reflux frequency, and swallowing difficulties. Outcomes include hernia recurrence at 1 and 3 years, surgical complications, hospital stay length, and patient-reported symptom changes. The total follow-up period extends to 3 years with regular assessments to monitor safety and efficacy.

This research aims to determine if hip replacement surgery arthroplasty can reduce the need for additional operations compared to internal fixation in elderly patients with an undisplaced femoral neck fracture. Patients aged 75 years and older with this type of fracture will be included and randomly assigned to one of two treatments through the Swedish Fracture Register platform. The study focuses on combining reoperation rates and mortality into a single main outcome measure to evaluate which treatment offers better results. Participants will receive either arthroplasty, which may be hemi or total hip replacement depending on the patients condition and surgeons decision, or internal fixation using screws, pins, or a sliding hip screw device based on hospital routine. The study is a randomized controlled trial without blinding, comparing these two device-based treatments for hip fractures in elderly patients. During the study, researchers will monitor the combined rate of reoperations and mortality for 1 to 2 years after surgery. Additional outcomes include reoperation rates, short- and long-term mortality, and patient-reported physical function one year after surgery. Participants will be followed up to assess these outcomes, with care taken to track their progress and safety over the study period.