Nissen versus Toupet fundoplication: results of a randomized and multicenter trial.
BACKGROUND
Laparoscopic Toupet fundoplication (TF) is reported to be as effective as Nissen (NF), but to be associated with fewer unfavorable postoperative side-effects. This study evaluates the one- and three-year clinical outcome of 140 randomized patients after a laparoscopic NF or TF.


METHODS
Inclusion criteria included patients over 16 years old with complications of gastro-oesophageal reflux disease (GORD) and persistence or recurrence of symptoms after three months of treatment. Subjects with a previous history of gastric surgery or repeated fundoplication, brachy-oesophagus or severe abnormal manometry results were excluded. Seventy-seven NF and 63 TF were performed. The severity of symptoms was assessed before and after the procedure.


RESULTS
One hundred and twenty-one of the 140 patients after one year, and 118 after three years, were evaluated and no statistically significant clinical difference was observed. The level of satisfaction concerning the outcome of the operation remained high after one or three years regardless of the type of fundoplication performed.


CONCLUSIONS
Functional complications after NF are not avoided with TF.
Guérin
E
E
Department of Digestive Surgery, Centre Hospitalier Universitaire de Charleroi, 92 Blv Paul Janson, 6000, Charleroi, Belgium.
Bétroune
K
K
Closset
J
J
Mehdi
A
A
Lefèbvre
J C
JC
Houben
J J
JJ
Gelin
M
M
Vaneukem
P
P
El Nakadi
I
I
D003680:Deglutition Disorders / Q000209:etiology; D004884:Eructation; D005260:Female; D005414:Flatulence / Q000209:etiology; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D017060:Patient Satisfaction; D011030:Pneumothorax / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D016896:Treatment Outcome
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