Impact of Toupet Versus Nissen Fundoplication on Dysphagia in Patients With Gastroesophageal Reflux Disease and Associated Preoperative Esophageal Dysmotility: A Systematic Review and Meta-Analysis

Hajibandeh, Shahin; Hajibandeh, Shahab; Pugh, M T; Winters, David; Hobbs, Nicholas; Tarazi, Munir; Panda, Nilanjan; Dalmia, Sanjay; Mansour, Moustafa; Malik, Sohail

doi:10.1177/1553350618799549

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…Dysphagia is a common post‐operative symptom in patients undergoing fundoplication. Some studies suggested that a 360° fundoplication was associated with more frequent dysphagia than partial fundoplication 36 . In this cohort, close to 45% of patients complained of dysphagia preoperatively compared to 10% post‐operatively.…”

Section: Discussionmentioning

confidence: 65%

Does composite repair of giant paraoesophageal hernia improve patient outcomes?

Lee

Khoma

Mendu³

et al. 2020

ANZ Journal of Surgery

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Background Paraoesophageal hernia (PEH) is often symptomatic and reduces patients' quality of life (QoL). There is ongoing debate regarding the most effective surgical technique to repair giant PEH. This study aimed to see if an elective laparoscopic non‐mesh composite technique of giant PEH repair offered an advantage in symptom control, hernia recurrence, QoL, morbidity and mortality. Methods Data were extracted from a prospectively maintained database of patients undergoing hiatal hernia repair. Composite hernia repairs from inception for giant PEH between March 2009 and December 2015 were included. Perioperative mortality, complications, hernia recurrence rates, prevalence, recurrence of symptoms and QoL were included in analysis. Results Inclusion criteria were met by 218 patients. Mean age was 70 (49–93). The average hernia size was 62% (range 30–100%; SD 21). There was one perioperative death and three significant complications (Clavien–Dindo grade III and IV). Recurrence rate was 24.8%. Without recurrence, QoL improved significantly across all domains. Recurrence of hiatus hernia reduced QoL. Surgery resulted in resolution of symptoms other than dysphagia which was incompletely improved. Patients' overall satisfaction with surgery was high. Conclusion Composite repair of giant PEH is safe with overall good outcomes. Majority of hernia recurrence are small and asymptomatic. Hernia recurrence negatively affected long‐term QoL scores.

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Section: Discussionmentioning

confidence: 65%

Does composite repair of giant paraoesophageal hernia improve patient outcomes?

Lee

Khoma

Mendu³

et al. 2020

ANZ Journal of Surgery

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“…Therefore, it was considered advisable in patients with significant pre-op esophageal dysmotility and dysphagia without GERD [11]. However, more recent studies have shown no difference in GERD symptom control or patient satisfaction after both methods [12][13][14][15][16]. Furthermore, Nissen fundoplication is associated with more significant side effects, including post-op dysphagia [12][13][14][15], even in the absence of pre-operative esophageal dysmotility [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, more recent studies have shown no difference in GERD symptom control or patient satisfaction after both methods [12][13][14][15][16]. Furthermore, Nissen fundoplication is associated with more significant side effects, including post-op dysphagia [12][13][14][15], even in the absence of pre-operative esophageal dysmotility [12]. Toupet fundoplication is the preferred anti-reflux surgery for some surgeons who believe it yields similar symptom control with decreased incidence of postoperative dysphagia requiring revision [13].…”

Section: Discussionmentioning

confidence: 99%

A Rare Occurrence of Rotational Retro-Esophageal Gastric Body Herniation Through a Nissen Fundoplication

Lin¹,

Melkonian²,

Okeke³

et al. 2022

Cureus

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Anti-reflux procedures have become a mainstay in managing gastroesophageal reflux disease (GERD) and hiatal hernia. Unfortunately, post-operative events such as breakdown of the wrap, downward slippage, or transdiaphragmatic herniation of an intact wrap cause these procedures to fail and create complications such as recurrent hiatal hernia and reflux dysphagia, regurgitation, and obstruction requiring revision surgery. We discuss a case of a rotational retro-esophageal herniation of the gastric body through a Nissen fundoplication presenting as obstruction, dysphagia, and regurgitation, highlighting the peculiar nature of this presentation and the ease of misdiagnosis given its rarity.

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“…However, these partial fundoplications are generally considered not as durable as a Nissen fundoplication, 23 while some authors suggests the recurrence rates are not statistically higher when a partial fundoplication is performed, but robust long term data is still being gathered. [24][25][26][27][28][29]…”

Section: Laparoscopic Partial Fundoplication-toupet and Dor Fundoplicationsmentioning

confidence: 99%

Refractory Gastroesophageal Reflux Disease: Surgical Perspective from a Multi-Disciplinary Practice

Grimsley

Meyer

Velanovich

2021

Foregut

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From the medical perspective, "refractory" gastroesophageal reflux disease (GERD) is symptomatic pathologic acid reflux that is not responsive to medical management, usually in the form of proton pump inhibitors (PPI). The basis of this approach is not to eliminate volume reflux, but to make reflux imperceptible by eliminating the stomach's ability to produce acid. Refractory, in this view, means that elimination of gastric acid does not lead to elimination of symptoms. GERD is protean in its manifestations and severity, both from the standpoint of symptoms, but also pathological manifestations, such as esophagitis, Barrett's esophagus, and eventual esophageal adenocarcinoma. The constellation of GERD manifestations, both typical and atypical, can have varying effects on the patient's quality of life. 1 Most quality of life decline is generally driven by symptoms, however other aspects can also contribute, such as the need to take medication indefinitely, medications' possible untoward effects, and concerns about neoplasia development. The only way to truly "cure" both acid and volume reflux is surgical. Therefore, from the surgical perspective, refractory GERD is diagnosed in the patient for whom reflux has produced such a detriment in their quality of life that they wish something more than medication.The purpose of this article is to discuss who should be considered for anti-reflux surgery (ARS), selection of operation, and pitfalls in patient selection. Our opinion is informed by our multidisciplinary approach to esophageal and swallowing disorders at the Joy McCann Culverhouse Center for Swallowing Disorders at the

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Impact of Toupet Versus Nissen Fundoplication on Dysphagia in Patients With Gastroesophageal Reflux Disease and Associated Preoperative Esophageal Dysmotility: A Systematic Review and Meta-Analysis

Cited by 20 publications

References 19 publications

Does composite repair of giant paraoesophageal hernia improve patient outcomes?

Does composite repair of giant paraoesophageal hernia improve patient outcomes?

A Rare Occurrence of Rotational Retro-Esophageal Gastric Body Herniation Through a Nissen Fundoplication

Refractory Gastroesophageal Reflux Disease: Surgical Perspective from a Multi-Disciplinary Practice

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