title: Effectiveness of laparoscopic total and partial fundoplication on extraesophageal manifestations of gastroesophageal reflux disease:  a randomized study.
abstract: The aim of the present study was to evaluate the clinical effect of partial and total fundoplication on extraesophageal symptoms in a selected cohort of patients with gastroesophageal reflux disease (GERD). Hundred patients with documented GERD were randomized to either undergo floppy Nissen (n = 50) or Toupet fundoplication (n = 50). Symptom scores of cough, asthma, hoarseness, and distortion of taste were prospectively evaluated using a standardized symptom questionnaire before surgery and at 3- and 12-month follow-up. Statistical significance was set at a P-value of 0.05. All evaluated symptoms exhibited substantial improvement after Nissen fundoplication at 3- and 12-month follow-up. Similar therapeutic results were documented for Toupet fundoplication, although statistical significance could not be reached for asthma at long-term follow-up. In conclusion, the application of laparoscopic fundoplication is justified for patients with documented GERD and atypical symptoms refractory to medical treatment. Toupet fundoplication may have a lesser effect on asthma.
authors.affiliation: Department of General Surgery, General Hospital Zell am See, Zell am See, Austria. o.koch@sbg.at
authors.forename: Oliver O
authors.initials: OO
authors.lastname: Koch
authors.forename: Stavros A
authors.initials: SA
authors.lastname: Antoniou
authors.forename: Adolf
authors.initials: A
authors.lastname: Kaindlstorfer
authors.forename: Kai U
authors.initials: KU
authors.lastname: Asche
authors.forename: Frank A
authors.initials: FA
authors.lastname: Granderath
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome