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Laparoscopic Nissen Versus Toupet Fundoplication: Assessment of Operative Outcomes.
MedLine Citation:
PMID:  21859310     Owner:  NLM     Status:  Publisher    
Abstract Background: This study was designed to analyze the outcomes of Nissen fundoplication (NF) versus Toupet fundoplication (TF) in patients undergoing laparoscopic antireflux surgery (LARS). Methods: All perioperative data, operative/postoperative complications, and follow-up data were prospectively recorded. All patients were seen on the 2nd month postoperatively and by yearly intervals thereafter. All patients have at least 12-month follow-up. Using SPSS software, groups were compared by t-test and chi-square tests as appropriate. Results: One thousand consecutive patients underwent primary LARS from May 2004 to August 2009. Six hundred eighty-four patients had NF and 316 had TF fundoplication. The mean follow-up of the NF (51.26 months) group was slightly longer than the TF group (43.53 months) (P=.018). There was no mortality and conversion. Esophageal perforation, jejunal perforation, and pulmonary emboli were the sole three major complications in separate patients. Dysphagia occurred in 15.4% and 9.9% in NF and TF, respectively (P=.001). Corresponding numbers for bloating were 19.6% and 10.8% in NF and TF, respectively (P=.001). Seventeen patients underwent reinterventions such as dilatation and re-do surgery and all 17 were in the NF group (P<.05). All other minor complications were similar except hiccups, which were seen in 30 patients and all were in the NF group (P<.05). Recurrence of reflux was observed in 1.8% and 2.2% of the NF and TF, respectively (P=.620). Conclusion: Both NF and TF are effective procedures in controlling the acid-reflux symptoms. The functional side effects appear more often in the NF group. These side effects can be minimized and reinterventions for severe/prolonged dysphagia can be avoided with TF.
Toygar Toydemir; Koray Tekin; Mehmet Ali Yerdel
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-22
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  -     ISSN:  1557-9034     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 General Surgery Department, Istanbul Surgery Hospital , Nisantasi-Istanbul, Turkey .
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