Meta-analysis of prospective randomized controlled trials comparing the efficacy of laparoscopic Nissen and Toupet Fundoplication in GERD therapy

doi:10.3877/cma.j.issn.1674-6899.2016.02.006

Abstract

Abstract:

Objective

To evaluate the value and significance of laparoscopicnissen fundoplication(LNF)and laparoscopictoupetfundoplication(LTF)in thetreatment of gastroesophageal reflux disease(GERD).

Methods

This paper searched the Cochrane library(issue 2, 2015); PubMed(1978 to 2016); Embase(1966.1 to 2016.5); CMB(1978.1 to 2016.5); VIP(1989.1 to 2016.5); CNKI(1989.1 to 2016.5); OVID(2006 to 2016.5)as well as hand searched several related journals and conference proceedings for the randomized controlled trials involving the comparison of the efficacy of the LNF versus LTF in patients with GERD.

Results

10 studies involving 1 468 patients were identified studies(LNF: 769, LTF: 701). When comparing LNF with LTF for thetreatment of GERD, LNF versus LTF showed no statistical difference in operation time(P=0.09). No statistical difference in 6-month and 1-year postoperative dysphagia, heartburn, abdominal distention, and thoracrodynia(P>0.05). It showed astatistical difference in postoperative DeMeester score(P=0.007). There was no statistical difference in 6-month and 2-year postoperative regurgitation(P=0.77).

Conclusion

The limited evidence suggested that if indications of surgery were graspedwell, the operation time was not shortenedby using LNF compared with LTF for the treatment of GERD.There was no significant difference after LNF or LTF in 6-month or 1-yearincidence of dysphagia, heartburn, abdominal distention, thoracodynia, and 2-year incidence of GERD recurrence rate.DeMeester score was significantly lower than that of LTF patients, but there was no significant difference in reflux symptoms.

Key words: Fundoplication, Gastroesophageal reflux, Meta analysis

Tuerxun Kahaer·, Aili Aikebaier·, Maimaitiming Maimaitiaili·, Tuerdi Maimaitituerxun·, Abudoureyimu Kelimu·. Meta-analysis of prospective randomized controlled trials comparing the efficacy of laparoscopic Nissen and Toupet Fundoplication in GERD therapy[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2016, 03(02): 72-80.

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Figures/Tables 9

References 27

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纳入研究	总数	Nissen	Toupet	男/女
C.Zorning	200	100	100	121/79
M.I.Booth	127	64	63	84/43
E.Guerin	140	77	63	86/54
Emmanuel.CH	33	14	19	18/15
John M．Shaw	100	50	50	60/40
Oliver	100	50	50	59/41
Henry L．Laws	39	23	16	19/20
Moreno.M	264	133	131	未说明
Mingfang.Qin	384	215	168	194/189
Bin Wang	84	43	43	44/40

纳入研究	总数	Nissen	Toupet	男/女
C.Zorning	200	100	100	121/79
M.I.Booth	127	64	63	84/43
E.Guerin	140	77	63	86/54
Emmanuel.CH	33	14	19	18/15
John M．Shaw	100	50	50	60/40
Oliver	100	50	50	59/41
Henry L．Laws	39	23	16	19/20
Moreno.M	264	133	131	未说明
Mingfang.Qin	384	215	168	194/189
Bin Wang	84	43	43	44/40

纳入研究	随机方法	分配隐藏	盲法	退出/失访	质量等级
C.zorning	抽签法	无	无	无	C
M.I.Booth	抽签法	信封法	无	10	B
E.Guerin	无	无	无	无	C
Emmanuel.CH	抽签法	信封法	无	无	B
John M．Shaw	抽签法	信封法	无	16	B
Oliver	抽签法	信封法	无	－/－	B
Henry L．Laws	抽签法	信封法	无	－/－	B
Moreno.M	随机表	信封法	单盲	－/－	A
Mingfang.Qin	抽签法	无	无	无	C
Bin Wang	计算机法	信封法	无	4	B

纳入研究	随机方法	分配隐藏	盲法	退出/失访	质量等级
C.zorning	抽签法	无	无	无	C
M.I.Booth	抽签法	信封法	无	10	B
E.Guerin	无	无	无	无	C
Emmanuel.CH	抽签法	信封法	无	无	B
John M．Shaw	抽签法	信封法	无	16	B
Oliver	抽签法	信封法	无	－/－	B
Henry L．Laws	抽签法	信封法	无	－/－	B
Moreno.M	随机表	信封法	单盲	－/－	A
Mingfang.Qin	抽签法	无	无	无	C
Bin Wang	计算机法	信封法	无	4	B

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