Resultados de la fundoplicatura laparoscópica en la enfermedad por reflujo gastroesofágico con síntomas atípicos

Liaño, Álvaro Díaz de; Zegarra, Sergio Cesar Oyarce; Olivera, Eduardo; Yárnoz, Concepción; Artieda, Cristina; Romeo, Ignacio J.; Ortiz, Héctor

doi:10.1016/s0009-739x(07)71314-3

Cited by 4 publications

(5 citation statements)

References 21 publications

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“…As described below, the diagnostic criteria vary significantly between studies. The characteristics of the studies included are described in Table 1 . One study has been excluded owing to overlapping patient populations …”

Section: Resultsmentioning

confidence: 99%

“…Among the trials using pH tests, the criteria used to perform the diagnosis were unspecified or were significantly different across studies (Table 2). As described in Table 1, some studies included patients with LPR on the basis of esophagitis (Los Angeles Classification) and 1 study excluded patients with esophagitis …”

Section: Resultsmentioning

confidence: 99%

“…The precise symptoms and signs used to assess the effectiveness of medical treatment are described in Table 3. The bias analysis of studies according to the tool to Assess Risk of Bias in Cohort Studies developed by the Clarity Group and Evidence Partners is described in Table 4 …”

Section: Resultsmentioning

confidence: 99%

“…Second, many studies based the diagnosis on symptoms associated with LPR and positive results of an esophageal single-probe pH test. Moreover, in many studies, the placement of the probe was not specified or the probe was placed in the distal esophagus, excluding the detection of proximal reflux episodes. This latter aspect remains a key condition for diagnosis of LPR .…”

Section: Discussionmentioning

confidence: 99%

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Surgical Treatment for Laryngopharyngeal Reflux Disease

Lechien

Dapri

Dequanter

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Laryngopharyngeal reflux (LPR) is a prevalent disease that is usually treated with diet, lifestyle modifications, and proton pump inhibitor therapy. However, nearly 10% to 30% of patients do not achieve adequate acid suppression even with high doses of proton pump inhibitors. For these patients with resistant disease, fundoplication may be recommended but the success rate of fundoplication surgery on laryngopharyngeal symptoms and findings remains uncertain. OBJECTIVE To determine whether fundoplication is associated with control of signs and symptoms in patients with LPR.EVIDENCE REVIEW A literature search was conducted on PubMed, Cochrane Library, and Scopus according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline to identify studies published between 1990 and 2018 about the efficacy of fundoplication on clinical outcomes of LPR. Three investigators screened publications for eligibility and exclusion based on predetermined criteria. Study design, patient characteristics, diagnostic method, exclusion criteria, treatment characteristics, follow-up, and quality of the outcome assessment were evaluated.FINDINGS Of the 266 studies identified, 34 met the inclusion criteria, accounting for 2190 patients with LPR (1270 women and 920 men; mean [SD] age at the time of surgery, 49.3 [6.3] years). A weighted mean of 83.0% of patients (95% CI, 79.7%-86.3%) experienced improvement and a weighted mean of 67.0% of patients (95% CI, 64.1%-69.9%) experienced a disappearance of symptoms, but there is a high level of methodological heterogeneity among studies according to diagnostic method, exclusion criteria, and outcomes used to assess the efficacy of fundoplication. A pH study without impedance study was used in most studies but with various inclusion criteria. According to results of an a priori assessment, the clinical outcomes used were overall poor, excluding many symptoms and findings associated with LPR. CONCLUSION AND RELEVANCEThe reported studies of fundoplication in LPR disease have important heterogeneity in method of diagnosis, exclusion criteria, symptoms, and signs assessed as therapeutic outcomes; therefore, this systematic review was nonconclusive regarding whether surgery for LPR disease is associated with effective control of sight and symptoms. Otolaryngologists, gastroenterologists, and surgeons must establish a diagnostic criterion standard, clear indications for surgery, and future clinical outcomes to precisely assess the effectiveness of treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Treatment for Laryngopharyngeal Reflux Disease

Lechien

Dapri

Dequanter

et al. 2019

JAMA Otolaryngol Head Neck Surg

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“…[1,13] A number of studies have found that the frequency of weak acid reflux and alkaline reflux in rGERC patients is significantly higher than that in normal GERC patients, which indicates that weak acid reflux and alkaline reflux may be important causes of rGERC. [21,27,28] However, drug treatment has a good effect on acid reflux (PH < 4), but a poor effect on weak acid reflux (4 < PH < 7) and alkaline reflux (PH > 7). [29,30] For these patients, laparoscopic fundoplication may be a good treatment choice.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic fundoplication in treating refractory gastroesophageal reflux-related chronic cough: A meta-analysis

Liu¹,

Deng²,

Zhang³

et al. 2023

Medicine

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Background: Gastroesophageal reflux-related chronic cough (GERC), is one common type of chronic cough. Drug treatment is effective for some GERC patients. But, there is refractory GERC (rGERC). For rGERC, fundoplication may be the only effective method. However, there were very few studies about laparoscopic fundoplication in treating rGERC, and the cure rate of fundoplication in treating rGERC was unknown. So there is a question, what is the cure rate of fundoplication in treating rGERC? To solve this question, we performed this meta-analysis.Methods: The PRISMA strategy and Cochrane collaboration method were used for this study. Our study was registered with PROSPERO (ID: CRD42021251072). We searched PubMed, Medline, Web of Science, and the Cochrane databases from 1990 to December 2022. The meta-analysis was performed with Review Manager 5.4 and Stata 14.Results: After selection and exclusion, 8 articles out of 672 were included. The meta-analysis showed the cure rate of laparoscopic fundoplication in treating rGERC was 62% (95% confidence interval: 53-71%), with no deaths in 503 patients. There was no significant heterogeneity or bias in the meta-analysis.Conclusions: In terms of safety, laparoscopic fundoplication is quite reliable offered by skilled surgeons. In terms of cure rate, laparoscopic fundoplication could completely heal two-thirds of rGERC patients; however, there are still some patients who can not be completely cured by fundoplication.

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