Clinical Outcomes of a Laparoscopic Total vs a 270° Posterior Partial Fundoplication in Chronic Gastroesophageal Reflux Disease

Abstract

IMPORTANCEThe efficacy of fundoplication operations in the management of gastroesophageal reflux disease (GERD) has been documented. However, few prospective, controlled series report long-term (>10 years) efficacy and postfundoplication concerns, particularly when comparing various types of fundoplication.OBJECTIVE To compare long-term (>15 years) results regarding mechanical complications, reflux control, and quality of life between patients undergoing posterior partial fundoplication (PF) or total fundoplication (TF) (270°vs 360°) in surgical treatment for GERD.

Long-term Efficacy of Total and Partial Posterior Fundoplication to Treat Gastroesophageal Reflux Disease

“…One might therefore think that the debate between total vs partial fundoplication is finally over, at least as far as the 270°partial fundoplication is concerned, with the results for other partial valves being certainly less favorable in terms of reflux control. 5 Analatos et al 1 do not mention or stress the importance of the surgical technique used in this study, which is clearly accountable for the consistent and homogenous results. It seems important to emphasize that the authors applied the principles of a tension-free repair, namely that of a floppy valve, total or partial, based on the correct identification and freeing of the upper part of the gastric fundus and extensive esophageal mobilization.…”

“…Long-term Efficacy of Total and Partial Posterior Fundoplication to Treat Gastroesophageal Reflux Disease Bernard Dallemagne, MD; Silvana Perretta, MD In this issue of JAMA Surgery, Analatos et al 1 report the results of a randomized clinical trial that compared total and 270°partial posterior fundoplication in patients with chronic gastroesophageal reflux disease (GERD) with more than 15 years of follow-up. 1 Clinical control of GERD and dysphagia rates were comparable, whereas dysphagia was higher after total fundoplication at the 3-year follow-up reported by the same group. 2 These results corroborate the evidence from a comparable study 3 in open surgery and a meta-analysis 4 of long-term results of laparoscopic fundoplication.…”

A Rare Occurrence of Rotational Retro-Esophageal Gastric Body Herniation Through a Nissen Fundoplication

“…Therefore, it was considered advisable in patients with significant pre-op esophageal dysmotility and dysphagia without GERD [11]. However, more recent studies have shown no difference in GERD symptom control or patient satisfaction after both methods [12][13][14][15][16]. Furthermore, Nissen fundoplication is associated with more significant side effects, including post-op dysphagia [12][13][14][15], even in the absence of pre-operative esophageal dysmotility [12].…”

Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review

“…Laparoscopic Nissen fundoplication remains the current reference gold standard and has been shown to be safe, effective, and durable when performed in specialized centers [11]. Systematic reviews and meta-analyses [12], randomized clinical trials [13], and recent recommendations [14] suggest that the Toupet fundoplication provides equivalent results in terms of reflux control and a lower rate of side effects compared to Nissen fundoplication.…”