Evidence-Based Appraisal of Antireflux Fundoplication

Catarci, Marco; Gentileschi, Paolo; Papi, Claudio; Carrara, Alessandro; Marrese, Renato; Gaspari, Achille; Grassi, G

doi:10.1097/01.sla.0000114225.46280.fe

Cited by 277 publications

(217 citation statements)

References 106 publications

Supporting

Mentioning

178

Contrasting

Unclassified

Order By: Relevance

“…However, the Nissen procedure is often followed by troublesome effects. [1][2][3] To reduce the risk of these, partial fundoplications have been developed, and these modifications have been tested in randomized trials. 1;4-6 In the absence of late objective outcomes, some have questioned the durability of partial fundoplications, 7-10 even though longer term clinical outcomes from the trials actually support the application of anterior 180˚ and posterior 270˚ partial fundoplication techniques.…”

Section: Introductionmentioning

confidence: 99%

Objective Outcomes 14 Years After Laparoscopic Anterior 180-Degree Partial Versus Nissen Fundoplication

Broeders

Watson

et al. 2013

Annals of Surgery

View full text Add to dashboard Cite

Please note that any alterations made during the publishing process may not appear in this version. Objective Outcomes 14 Years after Laparoscopic Anterior 180˚ Partial versus Nissen FundoplicationResults from a Randomized Trial Results: 18 patients (8 anterior, 10 Nissen) underwent objective testing and had a symptom profile similar to those who did not (n=59) have testing. Total esophageal acid exposure time and the total number of acid and weakly acidic reflux episodes per 24 h were higher after anterior fundoplication than after Nissen fundoplication. Proximal, mid-esophageal and distal reflux were proportionately increased after anterior 180˚ fundoplication. The number of liquid and mixed reflux episodes were also higher after anterior fundoplication, which was accompanied by higher clinical heartburn scores. There were no differences in gas reflux, gastric belches and supragastric belches, which is in line with the observation that gasrelated symptoms were similar for both groups. Mean LES resting and relaxation nadir pressure were lower after anterior fundoplication, which was reflected by lower dysphagia scores. Patient satisfaction is similar after both procedures.Conclusions: At 14 years after randomization, this study demonstrated that acid, weakly acidic, liquid and mixed reflux episodes are more common after anterior 180˚ fundoplication compared to Nissen fundoplication. On the other hand, gas reflux and gastric belching and patient satisfaction are similar for both procedures. Mean LES resting and relaxation nadir pressure are lower after anterior fundoplication. Overall these findings suggests less effective 4Archived at Flinders University: dspace.flinders.edu.au 5 reflux control after anterior 180˚ partial fundoplication, offset by less dysphagia, leading to a clinical outcome which is equivalent to Nissen fundoplication at late follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%

Objective Outcomes 14 Years After Laparoscopic Anterior 180-Degree Partial Versus Nissen Fundoplication

Broeders

Watson

et al. 2013

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…As the Catarci et al (5) study, the methodological quality of the included studies was very poor, and most of these studies dated from the early of the 90 decade, when the laparoscopy was in the beginning. Other relevant points are the unclear outcome measures and statistical analysis, as detection of publication bias.…”

Section: Discussionmentioning

confidence: 99%

“…The search for better evidence about this subject is growing along this decade. Catarci et al (5) , in a systematic review with meta-analysis, analyzed nine studies comparing total and partial fundoplications: six with open and three with laparoscopic access. They did not find any statistical difference between the groups in the outcomes dysphagia and recurrence of acid reflux.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis

Ramos

Lustosa²,

Almeida

et al. 2011

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Although the high incidence of gastroesophageal reflux disease (GERD) in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. Objective -To bring more clear evidence in the comparison between total and partial fundoplication. Data sources -A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration) was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. Results -Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001) in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. Conclusion -The partial fundoplication has lower incidence of obstructive side effects.

show abstract

“…When the SGV were not divided, the anterior wall of gastric fundus was used for the fundoplication, and not the posterior wall 16,17,18 . A metanalysis published by Catarci et al 19 concluded that the routine division of SGV had no advantage. However, criticism was made to this study, concerning specifi c aspects related to the gastric fundus mobilization such as: instruments, experienced surgical team and the number of different surgeons performing the procedure 20 .…”

Section: Introductionmentioning

confidence: 99%

Randomized trial of total fundoplication and fundal mobilization with or without division of short gastric vessels: a short-term clinical evaluation

et al. 2007

View full text Add to dashboard Cite

PURPOSE: Evaluate short results after fundoplication procedure, concerning the division of short gastric vessels. METHODS: A prospective randomization of 90 patients with indication for hiatoplasty and total fundoplication with fundus mobilization was performed. They were divided into two groups: no SGV division (group A, n= 46) and with SGV division (Group B, n=44), although in both groups the gastric fundus was mobilized to perform a floppy valve. Early outcome with clinical follow up (1 year) was observed. RESULTS: Both groups were similar regarding preoperative parameters and severity of gastroesophageal reflux disease (GERD). No difference in morbidity was observed during hospital stay. Nevertheless, the median operating time was 80,2 minutes in group A and 94,1 minutes (p=0,021) in Group B. Transitory dysphagia during the first year was significantly lower in group B (46,6% versus 23,2%, p=0,012). However, in 12 months clinical outcome was similar in both groups (clinical symptoms of GERD, persistent dysphagia and reoperations). CONCLUSION: There was no improvement in routine division of SGV in total fundoplication procedure when the gastric fundus was mobilized.

show abstract

Evidence-Based Appraisal of Antireflux Fundoplication

Cited by 277 publications

References 106 publications

Objective Outcomes 14 Years After Laparoscopic Anterior 180-Degree Partial Versus Nissen Fundoplication

Objective Outcomes 14 Years After Laparoscopic Anterior 180-Degree Partial Versus Nissen Fundoplication

Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis

Randomized trial of total fundoplication and fundal mobilization with or without division of short gastric vessels: a short-term clinical evaluation

Contact Info

Product

Resources

About