Resultados de la funduplicatura laparoscópica en el tratamiento de los síntomas extradigestivos del reflujo gastroesofágico

Carrasquer, Aurora; Targarona, Eduardo M.; Marinello, Franco; Batlle, Xavier Luna i; Trías, Manuel

doi:10.1016/j.ciresp.2011.12.008

Cited by 4 publications

(5 citation statements)

References 26 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%

“…In 65.6% of included studies (21), symptoms were evaluated mainly with unstandardized composite scores (Table 1). Concerning findings of LPR, 9 studies assessed laryngoscopic findings, of which 8 assessed both symptoms and signs of LPR . The evaluation of clinical findings with laryngoscopy was performed with a reflux finding score, an unstandardized composite instrument, or without an instrument.…”

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: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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