Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? systematic review and meta-analysis.
نویسندگان
چکیده
CONTEXT Although the high incidence of gastroesophageal reflux disease (GERD) in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. OBJECTIVE To bring more clear evidence in the comparison between total and partial fundoplication. DATA SOURCES A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration) was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. RESULTS Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001) in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. CONCLUSION The partial fundoplication has lower incidence of obstructive side effects.
منابع مشابه
Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms: a systematic review and meta-analysis.
PURPOSE Studies of endoscopic application of radiofrequency energy to the lower esophageal sphincter for gastroesophageal reflux control have produced conflicting reports of its effectiveness. This study aimed to conduct a meta-analysis of randomized controlled trials and cohort studies to assess the impact of this treatment. METHODS Twenty studies were included. Outcomes analyzed included ga...
متن کاملPartial versus Complete Fundoplication for the Correction of Pediatric GERD: A Systematic Review and Meta-Analysis
BACKGROUND There is no consensus as to what extent of "wrap" is required in a fundoplication for correction of gastroesophageal reflux disease (GERD). OBJECTIVE To evaluate if a complete (360 degree) or partial fundoplication gives better control of GERD. METHODS A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Scre...
متن کاملLaparoscopic Anterior 180 ̊ versus Nissen Fundoplication for Gastroesophageal Reflux Disease Systematic Review and Meta-analysis of Randomized Clinical Trials
متن کامل
Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease.
BACKGROUND Laparoscopic Nissen fundoplication (LNF) is currently considered the surgical approach of choice for gastro-oesophageal reflux disease (GORD). Laparoscopic Toupet fundoplication (LTF) has been said to reduce troublesome dysphagia and gas-related symptoms. A systematic review and meta-analysis of randomized clinical trials (RCTs) was performed to compare LNF and LTF. METHODS Four el...
متن کاملcollis gastRoplasty associated to paRcial oR total fundoplication: expeRimental study
headings – Esophagitis, peptic. Esophageal stenosis. Models, animal. abstRact – Background Reflux esophagitis complicated by stenosis and shortening of the organ is a difficult disease to surgical treatment with frequent failure. The Collis gastroplasty associated with a partial or total fundoplication can be employed in this situation. Aim To evaluate the technique of fundoplication with parti...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Arquivos de gastroenterologia
دوره 48 4 شماره
صفحات -
تاریخ انتشار 2011