{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:35:32Z","timestamp":1792650932804,"version":"4.5.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2010,7,16]],"date-time":"2010-07-16T00:00:00Z","timestamp":1279238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"University Medical Center Utrecht Alexandre Suerman"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Laparoscopic Nissen fundoplication (LNF) is currently considered the surgical approach of choice for gastro-oesophageal reflux disease (GORD). Laparoscopic Toupet fundoplication (LTF) has been said to reduce troublesome dysphagia and gas-related symptoms. A systematic review and meta-analysis of randomized clinical trials (RCTs) was performed to compare LNF and LTF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four electronic databases (MEDLINE, Embase, Cochrane Library and ISI Web of Knowledge CPCI-S) were searched and the methodological quality of included trials was evaluated. Outcomes included recurrent pathological acid exposure, oesophagitis, dysphagia, dilatation for dysphagia and reoperation rate. Results were pooled in meta-analyses as risk ratios (RRs) and weighted mean differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven eligible RCTs comparing LNF (n = 404) with LTF (n = 388) were identified. LNF was associated with a significantly higher prevalence of postoperative dysphagia (RR 1\u00b761 (95 per cent confidence interval 1\u00b706 to 2\u00b744); P = 0\u00b702) and dilatation for dysphagia (RR 2\u00b745 (1\u00b706 to 5\u00b768); P = 0\u00b704). There were more surgical reinterventions after LNF (RR 2\u00b719 (1\u00b709 to 4\u00b740); P = 0\u00b703), but no differences regarding recurrent pathological acid exposure (RR 1\u00b726 (0\u00b782 to 1\u00b795); P = 0\u00b729), oesophagitis (RR 1\u00b720 (0\u00b778 to 1\u00b785); P = 0\u00b740), subjective reflux recurrence, patient satisfaction, operating time or in-hospital complications. Inability to belch (RR 2\u00b704 (1\u00b719 to 3\u00b749); P = 0\u00b7009) and gas bloating (RR 1\u00b758 (1\u00b721 to 2\u00b705); P &amp;lt; 0\u00b7001) were more prevalent after LNF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LTF reduces postoperative dysphagia and dilatation for dysphagia compared with LNF. Reoperation rate and prevalence of gas-related symptoms were lower after LTF, with similar reflux control. These results provide level 1a support for the use of LTF as the posterior fundoplication of choice for GORD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.7174","type":"journal-article","created":{"date-parts":[[2010,7,16]],"date-time":"2010-07-16T14:06:53Z","timestamp":1279289213000},"page":"1318-1330","source":"Crossref","is-referenced-by-count":265,"title":["Systematic review and meta-analysis of laparoscopic Nissen (posterior total)<i>versus<\/i>Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease"],"prefix":"10.1093","volume":"97","author":[{"given":"J A J L","family":"Broeders","sequence":"first","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F A","family":"Mauritz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Ahmed Ali","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W A","family":"Draaisma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J P","family":"Ruurda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H G","family":"Gooszen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J P M","family":"Smout","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I A M J","family":"Broeders","sequence":"additional","affiliation":[{"name":"Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E J","family":"Hazebroek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,7,16]]},"reference":[{"key":"2021070910492716200_bib1","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1136\/gut.2006.115287","article-title":"Proton pump inhibitor-therapy refractory gastro-oesophageal reflux disease patients, who are they?","volume":"56","author":"Bredenoord","year":"2007","journal-title":"Gut"},{"key":"2021070910492716200_bib2","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1001\/jama.285.18.2331","article-title":"Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial","volume":"285","author":"Spechler","year":"2001","journal-title":"JAMA"},{"key":"2021070910492716200_bib3","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1111\/j.1365-2036.2007.03333.x","article-title":"Review article: The role of surgery in gastro-oesophageal reflux disease","volume":"25","author":"Vakil","year":"2007","journal-title":"Aliment Pharmacol Ther"},{"key":"2021070910492716200_bib4","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/01.sla.0000217667.55939.64","article-title":"Five-year subjective and objective results of laparoscopic and conventional Nissen fundoplication: a randomized trial","volume":"244","author":"Draaisma","year":"2006","journal-title":"Ann Surg"},{"key":"2021070910492716200_bib5","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/SLA.0b013e3181bcdaa7","article-title":"Ten-year outcome of laparoscopic and conventional Nissen fundoplication: randomized clinical trial","volume":"250","author":"Broeders","year":"2009","journal-title":"Ann Surg"},{"key":"2021070910492716200_bib6","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1055\/s-2007-1004194","article-title":"Current status and trends in laparoscopic antireflux surgery: results of a consensus meeting. 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