Meta-analysis of laparoscopic total (Nissen) versus posterior (Toupet) fundoplication for XXXX based on randomized clinical trials.

@entity1 @entity1282 @entity354
BACKGROUND: Laparoscopic Nissen fundoplication (LNF) is the standard procedure for surgical management of @entity354 ( @entity354 ). Laparoscopic Toupet fundoplication (LTF) is reported to be as effective as LNF but to be associated with a lower incidence of post-operative @entity1282 . This meta-analysis was performed to compare the two techniques with respect to reflux control and associated complications, particularly @entity1282 . METHODS: Pubmed, Medline, Embase and The Cochrane Library were searched. Only randomized controlled trials (RCTs) comparing LNF and LTF were included. Outcomes evaluated were occurrences of heartburn and associated complications (e.g. @entity1282 ) and degree of @entity1 's satisfaction at early (three to six months) and later (one to three years) post-operative periods. RESULTS: Of 939 @entity1 in seven RCTs, 478 received LNF and 461 received LTF. For both groups, control of reflux was good and occurrence of heartburn were similar. A lower incidence of post-operative @entity1282 for both early and later post-operative periods was observed for the LTF group. @entity1 's satisfaction following either procedure was similar. CONCLUSION: LNF and LTF are both safe and effective. LTF is truly associated with a lower occurrence of @entity1282 . However, LTF is more likely than LNF to be associated with early surgical complications. On the whole, post-surgical satisfaction ratios for the two groups were comparable.
