| Total vs partial fundoplication in the treatment of gastroesophageal reflux disease: a meta-analysis. | |
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MedLine Citation:
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PMID: 19289668 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To perform a meta-analysis of randomized trials comparing partial fundoplication (PF) with total (Nissen) fundoplication (TF) for gastroesophageal reflux disease in terms of morbidity, efficacy, and long-term symptomatology. DATA SOURCES: A structured Medline search for published studies. STUDY SELECTION: The available literature from 1975 until June 2007 was searched using the Medical Subject Headings of the National Library of Medicine term fundoplication and the free-text terms fundoplication, surgery, and reflux. Data were analyzed using Review Manager software (Cochrane Collaboration, Oxford, England). DATA EXTRACTION: Eleven trials were identified comparing TF with PF in 991 patients. DATA SYNTHESIS: Total fundoplication resulted in a significantly higher incidence of postoperative dysphagia (odds ratio [OR], 1.82-3.93; P < .001), bloating (OR, 1.07-2.56; P = .02), and flatulence (OR, 1.66-3.96; P < .001). No significant differences were noted in the incidence of esophagitis (OR, 0.72-2.7; P = .33), heartburn (OR, 0.48-1.52; P = .58), or persisting acid reflux (OR, 0.77-1.79; P = .45). The reoperation rate was significantly higher after TF compared with PF (OR, 1.13-3.95; P = .02). No significant differences were present in the proportion of patients experiencing a good or excellent long-term outcome (OR, 0.54-1.38; P = .53) or in the proportion of patients with a Visick I or II score (OR, 0.62-1.59; P = .99). CONCLUSIONS: Partial fundoplication is a safe and effective alternative to TF, resulting in significantly fewer reoperations and a better functional outcome. The poor quality of the included trials warrants caution in the interpretation of the results of this meta-analysis. |
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Authors:
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Oswald Varin; Berit Velstra; Stijn De Sutter; Wim Ceelen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 144 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-17 Completed Date: 2009-03-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 273-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Ghent University Hospital 2K12 IC, De Pintelaan 185, B-9000 Ghent, Belgium. oswald.varin@ugent.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Fundoplication
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adverse effects,
methods* Gastroesophageal Reflux / surgery* Humans Randomized Controlled Trials as Topic Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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