Five-Year Outcome After Laparoscopic Anterior Partial Versus Nissen Fundoplication: Four Randomized Trials
To compare longer term (5-year) outcomes for reflux control and postsurgery side effects after laparoscopic anterior (90° and 180°) partial versus Nissen fundoplication for gastroesophageal reflux. Laparoscopic Nissen fundoplication is the most frequently performed surgical procedure for gastroesoph...
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| Veröffentlicht in: | Annals of surgery 2012-04, Vol.255 (4), p.637-642 |
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| creator | BROEDERS, Joris A ROKS, David J JAMIESON, Glyn G DEVITT, Peter G BAIGRIE, Robert J WATSON, David I |
| description | To compare longer term (5-year) outcomes for reflux control and postsurgery side effects after laparoscopic anterior (90° and 180°) partial versus Nissen fundoplication for gastroesophageal reflux.
Laparoscopic Nissen fundoplication is the most frequently performed surgical procedure for gastroesophageal reflux. It achieves excellent control of reflux, but in some patients it is followed by troublesome side effects. To reduce the risk of side effects laparoscopic anterior partial fundoplication variants have been advocated, although some studies suggest poorer reflux control.
From 1995 to 2003, 461 patients with gastroesophageal reflux were enrolled in 4 randomized controlled trials comparing anterior partial versus Nissen fundoplication. Two trials evaluated anterior 180° and 2 anterior 90° partial fundoplication. The original trial data were combined, and a reanalysis from original data was undertaken to determine outcomes at 5 years follow-up. Reflux symptom control and side effects were evaluated in a blinded fashion using standardized questionnaires, including 0 to 10 analog scores (0 = no symptoms, 10 = severe symptoms).
At 5 years, patients who underwent an anterior 90° or 180° partial fundoplication had less side effects than those who underwent Nissen fundoplication and were equally satisfied with the overall outcome. Reflux control, measured by heartburn scores and antisecretory medication use, was similar for anterior 180° partial versus Nissen fundoplication, but inferior after anterior 90° partial versus Nissen fundoplication.
Anterior 180° partial fundoplication achieves durable control of reflux symptoms and fewer side effects compared with Nissen fundoplication. Reflux control after anterior 90° partial fundoplication appears less effective than after Nissen fundoplication. This data supports the use of anterior 180° partial fundoplication for the surgical treatment of gastroesophageal reflux. |
| doi_str_mv | 10.1097/SLA.0b013e31824b31ad |
| format | Article |
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Laparoscopic Nissen fundoplication is the most frequently performed surgical procedure for gastroesophageal reflux. It achieves excellent control of reflux, but in some patients it is followed by troublesome side effects. To reduce the risk of side effects laparoscopic anterior partial fundoplication variants have been advocated, although some studies suggest poorer reflux control.
From 1995 to 2003, 461 patients with gastroesophageal reflux were enrolled in 4 randomized controlled trials comparing anterior partial versus Nissen fundoplication. Two trials evaluated anterior 180° and 2 anterior 90° partial fundoplication. The original trial data were combined, and a reanalysis from original data was undertaken to determine outcomes at 5 years follow-up. Reflux symptom control and side effects were evaluated in a blinded fashion using standardized questionnaires, including 0 to 10 analog scores (0 = no symptoms, 10 = severe symptoms).
At 5 years, patients who underwent an anterior 90° or 180° partial fundoplication had less side effects than those who underwent Nissen fundoplication and were equally satisfied with the overall outcome. Reflux control, measured by heartburn scores and antisecretory medication use, was similar for anterior 180° partial versus Nissen fundoplication, but inferior after anterior 90° partial versus Nissen fundoplication.
Anterior 180° partial fundoplication achieves durable control of reflux symptoms and fewer side effects compared with Nissen fundoplication. Reflux control after anterior 90° partial fundoplication appears less effective than after Nissen fundoplication. This data supports the use of anterior 180° partial fundoplication for the surgical treatment of gastroesophageal reflux.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0b013e31824b31ad</identifier><identifier>PMID: 22418004</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Digestive system. Abdomen ; Endoscopy ; Female ; Follow-Up Studies ; Fundoplication - methods ; Gastroesophageal Reflux - surgery ; General aspects ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Laparoscopy ; Male ; Medical sciences ; Middle Aged ; Patient Satisfaction - statistics & numerical data ; Postoperative Complications - epidemiology ; Single-Blind Method ; Treatment Outcome ; Young Adult</subject><ispartof>Annals of surgery, 2012-04, Vol.255 (4), p.637-642</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c285t-41d5b09446a29ac49726f8df524de5c397431b73535d164acfce012d1e0966153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25777415$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22418004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BROEDERS, Joris A</creatorcontrib><creatorcontrib>ROKS, David J</creatorcontrib><creatorcontrib>JAMIESON, Glyn G</creatorcontrib><creatorcontrib>DEVITT, Peter G</creatorcontrib><creatorcontrib>BAIGRIE, Robert J</creatorcontrib><creatorcontrib>WATSON, David I</creatorcontrib><title>Five-Year Outcome After Laparoscopic Anterior Partial Versus Nissen Fundoplication: Four Randomized Trials</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>To compare longer term (5-year) outcomes for reflux control and postsurgery side effects after laparoscopic anterior (90° and 180°) partial versus Nissen fundoplication for gastroesophageal reflux.
Laparoscopic Nissen fundoplication is the most frequently performed surgical procedure for gastroesophageal reflux. It achieves excellent control of reflux, but in some patients it is followed by troublesome side effects. To reduce the risk of side effects laparoscopic anterior partial fundoplication variants have been advocated, although some studies suggest poorer reflux control.
From 1995 to 2003, 461 patients with gastroesophageal reflux were enrolled in 4 randomized controlled trials comparing anterior partial versus Nissen fundoplication. Two trials evaluated anterior 180° and 2 anterior 90° partial fundoplication. The original trial data were combined, and a reanalysis from original data was undertaken to determine outcomes at 5 years follow-up. Reflux symptom control and side effects were evaluated in a blinded fashion using standardized questionnaires, including 0 to 10 analog scores (0 = no symptoms, 10 = severe symptoms).
At 5 years, patients who underwent an anterior 90° or 180° partial fundoplication had less side effects than those who underwent Nissen fundoplication and were equally satisfied with the overall outcome. Reflux control, measured by heartburn scores and antisecretory medication use, was similar for anterior 180° partial versus Nissen fundoplication, but inferior after anterior 90° partial versus Nissen fundoplication.
Anterior 180° partial fundoplication achieves durable control of reflux symptoms and fewer side effects compared with Nissen fundoplication. Reflux control after anterior 90° partial fundoplication appears less effective than after Nissen fundoplication. This data supports the use of anterior 180° partial fundoplication for the surgical treatment of gastroesophageal reflux.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundoplication - methods</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>General aspects</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Kaplan-Meier Estimate</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Satisfaction - statistics & numerical data</subject><subject>Postoperative Complications - epidemiology</subject><subject>Single-Blind Method</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE-L1TAUxYMozpvRbyCSjbjqeJPctI27x-AbhYcjOgquSprcQoa2qUkr6Kc3Mk8FVwcOv3P_HMaeCbgUYJpXn477S-hBKFKildgrYf0DthNatpUQCA_ZDgBUhUbJM3ae8x2AwBaax-xMShQtAO7Y3SF8p-or2cRvttXFifh-WCnxo11sitnFJTi-n4sVYuIfbFqDHfkXSnnL_H3ImWZ-2GYflzE4u4Y4v-aHuCX-0RZzCj_J89tUMvkJezQUoacnvWCfD29ur95Wx5vrd1f7Y-Vkq9cKhdc9GMTaSmMdmkbWQ-sHLdGTdso0qETfKK20FzVaNzgCIb0gMHUttLpgL-_nLil-2yiv3RSyo3G0M8Utd0a2BhB1XUi8J135NCcauiWFyaYfnYDud8ldKbn7v-QSe35asPUT-b-hP60W4MUJsNnZcUh2diH_43TTNFgu_QWszIY6</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>BROEDERS, Joris A</creator><creator>ROKS, David J</creator><creator>JAMIESON, Glyn G</creator><creator>DEVITT, Peter G</creator><creator>BAIGRIE, Robert J</creator><creator>WATSON, David I</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120401</creationdate><title>Five-Year Outcome After Laparoscopic Anterior Partial Versus Nissen Fundoplication: Four Randomized Trials</title><author>BROEDERS, Joris A ; ROKS, David J ; JAMIESON, Glyn G ; DEVITT, Peter G ; BAIGRIE, Robert J ; WATSON, David I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c285t-41d5b09446a29ac49726f8df524de5c397431b73535d164acfce012d1e0966153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Digestive system. Abdomen</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundoplication - methods</topic><topic>Gastroesophageal Reflux - surgery</topic><topic>General aspects</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Kaplan-Meier Estimate</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Satisfaction - statistics & numerical data</topic><topic>Postoperative Complications - epidemiology</topic><topic>Single-Blind Method</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BROEDERS, Joris A</creatorcontrib><creatorcontrib>ROKS, David J</creatorcontrib><creatorcontrib>JAMIESON, Glyn G</creatorcontrib><creatorcontrib>DEVITT, Peter G</creatorcontrib><creatorcontrib>BAIGRIE, Robert J</creatorcontrib><creatorcontrib>WATSON, David I</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BROEDERS, Joris A</au><au>ROKS, David J</au><au>JAMIESON, Glyn G</au><au>DEVITT, Peter G</au><au>BAIGRIE, Robert J</au><au>WATSON, David I</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five-Year Outcome After Laparoscopic Anterior Partial Versus Nissen Fundoplication: Four Randomized Trials</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>255</volume><issue>4</issue><spage>637</spage><epage>642</epage><pages>637-642</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>To compare longer term (5-year) outcomes for reflux control and postsurgery side effects after laparoscopic anterior (90° and 180°) partial versus Nissen fundoplication for gastroesophageal reflux.
Laparoscopic Nissen fundoplication is the most frequently performed surgical procedure for gastroesophageal reflux. It achieves excellent control of reflux, but in some patients it is followed by troublesome side effects. To reduce the risk of side effects laparoscopic anterior partial fundoplication variants have been advocated, although some studies suggest poorer reflux control.
From 1995 to 2003, 461 patients with gastroesophageal reflux were enrolled in 4 randomized controlled trials comparing anterior partial versus Nissen fundoplication. Two trials evaluated anterior 180° and 2 anterior 90° partial fundoplication. The original trial data were combined, and a reanalysis from original data was undertaken to determine outcomes at 5 years follow-up. Reflux symptom control and side effects were evaluated in a blinded fashion using standardized questionnaires, including 0 to 10 analog scores (0 = no symptoms, 10 = severe symptoms).
At 5 years, patients who underwent an anterior 90° or 180° partial fundoplication had less side effects than those who underwent Nissen fundoplication and were equally satisfied with the overall outcome. Reflux control, measured by heartburn scores and antisecretory medication use, was similar for anterior 180° partial versus Nissen fundoplication, but inferior after anterior 90° partial versus Nissen fundoplication.
Anterior 180° partial fundoplication achieves durable control of reflux symptoms and fewer side effects compared with Nissen fundoplication. Reflux control after anterior 90° partial fundoplication appears less effective than after Nissen fundoplication. This data supports the use of anterior 180° partial fundoplication for the surgical treatment of gastroesophageal reflux.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22418004</pmid><doi>10.1097/SLA.0b013e31824b31ad</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Digestive system. Abdomen Endoscopy Female Follow-Up Studies Fundoplication - methods Gastroesophageal Reflux - surgery General aspects Humans Investigative techniques, diagnostic techniques (general aspects) Kaplan-Meier Estimate Laparoscopy Male Medical sciences Middle Aged Patient Satisfaction - statistics & numerical data Postoperative Complications - epidemiology Single-Blind Method Treatment Outcome Young Adult |
| title | Five-Year Outcome After Laparoscopic Anterior Partial Versus Nissen Fundoplication: Four Randomized Trials |
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