title: Nissen versus Dor fundoplication for treatment of gastroesophageal reflux disease: a blinded randomized clinical trial.
abstract: BACKGROUND
  Fundoplication techniques for treatment of gastroesophageal reflux are discussed concerning impairments and success. This randomized trial was conducted to compare Nissen's wrap and the anterior partial technique (Dor) concerning patients' quality of life (QoL) and functional data after a mid-term follow-up.
  
  
  METHODS
  In a 24-month period, 64 patients were equally randomized into group A (Nissen's fundoplication) and group B (180° anterior partial fundoplication). After a mean follow-up of 18 months, all patients were examined and interviewed using standardized QoL questionnaires (Gastrointestinal Quality of Life Index), Visick score, 24-hour pH-metry and esophageal manometry. Data of 57 patients (group A: 27, group B: 30) could be analyzed.
  
  
  RESULTS
  After partial fundoplication, 9 patients (30%) stated the operative results were worse than perfect. Only 2 patients (7%) evaluated the outcome after Nissen's fundoplication as unsuccessful (p = 0.04). However, postoperative Gastrointestinal Quality of Life Index showed no differences between groups (p = 0.5). Additionally, functional data were not different (DeMeester 10 vs. 12, p = 0.17, and lower esophageal sphincter pressure 13 vs. 12 mm Hg, p = 0.5).
  
  
  CONCLUSIONS
  The anterior partial fundoplication technique did not lead to disadvantages in postoperative QoL, physiological function and reflux control when compared to Nissen's approach in a mid-term follow-up.
authors.affiliation: Department of General, Visceral, Vascular and Thoracic Surgery, University Medicine Berlin, Charité Campus Mitte, Germany. wieland.raue@charite.de
authors.forename: W
authors.initials: W
authors.lastname: Raue
authors.forename: J
authors.initials: J
authors.lastname: Ordemann
authors.forename: C A
authors.initials: CA
authors.lastname: Jacobi
authors.forename: C
authors.initials: C
authors.lastname: Menenakos
authors.forename: A
authors.initials: A
authors.lastname: Buchholz
authors.forename: J
authors.initials: J
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D049630:Esophageal Sphincter, Lower / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult