A Meta-Analysis of Randomized Controlled Trials to Compare Long-Term Outcomes of Nissen and Toupet Fundoplication for XXXX .

@entity1 @entity11035 @entity2026 @entity86 @entity354
AIM: In recent years, several studies with large sample sizes and recent follow-up data have been published comparing outcomes between laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication. It is now timely to be re-evaluated and synthesized long-term efficacy and adverse events of both total and partial posterior fundoplication. MATERIALS AND METHODS: Electronic searches for RCTs comparing the outcome after laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication were performed in the databases of MEDLINE, EMBASE, and the Cochrane Center Register of Controlled Trials. The data of evaluation in positive and adverse results of laparoscopic Nissen fundoplication and laparoscopic Nissen fundoplication were extracted and compared using meta-analysis. RESULTS: 13 RCTs were ultimately identified involving 814 (52.05%) and 750 (47.95%) @entity1 who underwent laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication, respectively. The operative time, perioperative complications, @entity86 , recurrence, and the rates of medication adoption or re-operation due to recurrence were not significantly different between two groups. The two types of fundoplication both reinforced the anti-reflux barrier and elevated the lower esophageal sphincter pressure. However, rates of adverse results involving @entity2026 , @entity11035 , inability to belch and re-operation due to severe @entity2026 were significantly higher after LNF. In the subgroup analysis of wrap length <=2cm, laparoscopic Nissen fundoplication was associated with a significantly higher incidence of @entity86 . However, in the subgroup wrap length>2cm, the difference was not statistically significant. CONCLUSION: Laparoscopic Toupet fundoplication might be the better surgery approach for @entity354 with a lower rate of postoperative adverse results and equal effectiveness as Laparoscopic Nissen fundoplication.
