Laparoscopic anterior versus posterior fundoplication for gastroesophageal reflux disease: systematic review and meta-analysis of randomized clinical trials

Annals of Surgery
Joris A BroedersEric J Hazebroek

Abstract

To compare short- and long-term outcome after laparoscopic anterior fundoplication (LAF) versus posterior fundoplication (LPF) through a systematic review and meta-analysis of randomized clinical trials (RCTs). LPF is currently considered the surgical therapy of choice for gastroesophageal reflux disease (GERD). Alternatively, LAF has been alleged to reduce troublesome dysphagia and gas-related symptoms. Four electronic databases (MEDLINE, EMBASE, Cochrane Library, and ISI web of Knowledge CPCI-S) were searched for RCTs comparing primary LAF versus LPF for GERD. The methodological quality was evaluated to assess bias risk. Primary outcomes were esophageal acid exposure time, heartburn, Dakkak dysphagia score (0-45) and reoperation rate. Short- and long-term results were pooled separately in meta-analyses as risk ratios (RRs) and weighted mean differences (WMDs). Eleven reports on 7 eligible RCTs (anterior vs. posterior total [n = 5]; anterior vs. posterior partial [n = 2]) comparing LAF (n = 345) versus LPF (n = 338) were identified. Short-term (6-12 months) esophageal acid exposure time (3.3% vs. 0.8%: WMD 2.04; 95% confidence interval [CI] [0.84-3.24]; P < 0.001), heartburn (21% vs. 8%; RR 2.71; 95%CI [1.72-4.26]; P < 0.001) ...Continue Reading

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Citations

Apr 25, 2012·Langenbeck's Archives of Surgery·Christian A Gutschow, Arnulf H Hölscher
Aug 15, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·F A MauritzM Y A van Herwaarden-Lindeboom
Feb 4, 2014·Best Practice & Research. Clinical Gastroenterology·Marlies P SchijvenMark I van Berge Henegouwen
Dec 15, 2011·Annals of Surgery·Joris A BroedersAndré J Smout
Jul 14, 2018·The British Journal of Surgery·M A AmerJ L McCall
Aug 17, 2011·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·B H A von Rahden, C-T Germer
Apr 29, 2015·Asian Journal of Endoscopic Surgery·Yuko KitagawaTatsuya Miyazaki
Jul 10, 2019·Surgical Endoscopy·Brexton TurnerJon C Gould
Apr 21, 2017·Gut and Liver·Dalbir S Sandhu, Ronnie Fass
Jan 27, 2015·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·O O KochK Emmanuel
Oct 20, 2015·ANZ Journal of Surgery·Andrew G N RobertsonPeter J Lamb
Jun 8, 2011·The British Journal of Surgery·J A BroedersS K Thompson
Feb 14, 2015·World Journal of Surgery·Sarah K Thompson, David I Watson
Feb 2, 2017·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Pawanindra LalAmarender Singh Puri
Jul 31, 2021·Nature Reviews. Disease Primers·Ronnie FassMichael F Vaezi

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