title: Comparison of laparoscopic Nissen and Toupet fundoplication using a propensity score matching analysis.
abstract: OBJECTIVE
  Laparoscopic fundoplication (LF) has become a standard operative procedure for GERD-related diseases in Japan, although meta-analyses have mainly evaluated findings from Western countries. The propensity score matching method was used to compare and investigate the treatment outcomes of two fundoplication procedures (the Nissen and Toupet methods).
  
  
  METHODS
  Among 474 patients who underwent initial LF from December 1994 to April 2016, we extracted 401 cases (Nissen: 92 cases, Toupet: 309 cases), excluding 73 patients in whom follow-up was insufficient. We then matched 126 of these patients (63 per group).
  
  
  RESULTS
  The esophageal acid reflux time (%) was 12.2:2.8, being higher in the Nissen group than in the Toupet group (p < 0.001). Regarding the surgical outcome, the amount of bleeding was higher in the Nissen group (p = 0.001), and the number of hospitalization days following surgery was longer (p = 0.003). Furthermore, a significantly rate of postoperative difficulty in swallowing (%) was observed in the Nissen group, at 13:0 (p = 0.004). The recurrence rate (%) was 8:3, with no difference between the two groups (p = 0.243).
  
  
  CONCLUSIONS
  Although there was no marked difference in the recurrence rate between the two procedures, postoperative dysphagia was observed at a higher frequency with the Nissen method than the Toupet method.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan. qq2w2yb9@mist.ocn.ne.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Hoshino
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Omura
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Yano
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Se Ryung
authors.initials: SR
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Akimoto
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Mitsumori
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000453:epidemiology; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D057216:Propensity Score; D012008:Recurrence; D016896:Treatment Outcome
keywords: Gastroesophageal reflux disease (GERD); Nissen fundoplication; Propensity score matching analysis; Surgical outcomes; Toupet fundoplication