Format

Send to

Choose Destination
See comment in PubMed Commons below
ANZ J Surg. 2015 Sep;85(9):668-72. doi: 10.1111/ans.12476. Epub 2013 Nov 28.

Randomized controlled trial of laparoscopic anterior 180° partial versus posterior 270° partial fundoplication.

Author information

1
Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
2
Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia.
3
Department of Surgery, University of Queensland, Brisbane, Queensland, Australia.

Abstract

BACKGROUND:

Previous trials show good outcomes following anterior and posterior partial versus Nissen fundoplication for gastro-oesophageal reflux. However, it is unclear which partial fundoplication performs best. This study compared anterior 180° versus posterior 270° fundoplication.

METHODS:

At three hospitals, patients were randomized to anterior 180° versus posterior 270° partial fundoplication, and clinical outcomes were determined using a structured questionnaire at 3, 6 and 12 months. Heartburn, dysphagia and satisfaction were assessed using 0-10 analoue scales, and adverse outcomes and side effects were determined. Endoscopy, manometry and pH monitoring were performed 6 months after surgery.

RESULTS:

Forty-seven patients were randomized to anterior (n = 23) versus posterior (n = 24) fundoplication. Clinical outcomes for 93-98% of patients were available at each follow-up point. At 12 months, the mean heartburn score was higher following anterior fundoplication (2.7 versus 0.8, P = 0.045), although differences were not significant at earlier follow-up. Conversely, following posterior fundoplication, patients were less able to belch at 3 (56% versus 16%, P = 0.013) and 6 months (43% versus 9%, P = 0.017). No significant differences were demonstrated for dysphagia. Both groups had high rates of satisfaction with the outcome - 85% versus 86% satisfied at 12 months follow-up.

CONCLUSION:

Both partial fundoplications are effective treatments for gastro-oesophageal reflux. Posterior partial fundoplication is associated with less reflux symptoms offset by more side effects.

KEYWORDS:

fundoplication; gastro-oesophageal reflux disease; laparoscopy; randomized controlled trial

PMID:
24286198
DOI:
10.1111/ans.12476
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center