{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:59:43Z","timestamp":1776056383824,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although laparoscopic posterior fundoplication (LPF) i.e., Nissen or Toupet have the proven efficacy for controlling gastro\u2010esophageal reflux surgically, there remain problems with postoperative dysphagia and gas bloat syndrome. To decrease some of these postoperative complications, laparoscopic anterior fundoplication (LAF) was introduced. The aim of this study was to conduct a meta\u2010analysis and systematic review of randomized controlled trials (RCTs) to investigate the merits and drawbacks of LPF versus LAF for the treatment of gastro\u2010esophageal reflux disease (GERD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources, Study Selection, and Review Methods<\/jats:title><jats:p>A search of Medline, Embase, Science Citation Index, Current Contents, PubMed, ISI Web of Science, and the Cochrane Database identified all RCTs comparing different types of LPF and LAF published in the English Language between 1990 and 2013. The meta\u2010analysis was prepared in accordance with the Preferred Reporting Items for Systematic reviews and Meta\u2010analyses (PRISMA) statement. Data was extracted and analyzed on ten variables which include dysphagia score, heartburn rate, redo operative rate, operative time, overall complications, rate of conversion to open, Visick grading of satisfaction, overall satisfaction, length of hospital stay, and postoperative 24\u2010h pH scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Synthesis<\/jats:title><jats:p>Nine trials totaling 840 patients (anterior = 425, posterior = 415) were analyzed. There was a significant reduction in the odds ratio for dysphagia in the LAF group compared to the LPF group. Conversely, significant reduction in the odds ratio for heartburn was observed for LPF compared to LAF. Comparable effects were noted for both groups for other variables which include redo surgery, operating time, overall complications, conversion rate, Visick\u2019s grading, patients\u2019 satisfaction, length of hospital stay, and postoperative 24\u2010h pH scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on this meta\u2010analysis, LPF compared to LAF is associated with significant reduction in heartburn at the expense of higher dysphagia rate on a short\u2010 and medium\u2010term basis. We therefore conclude that LPF is a better alternative to LAF for controlling GERD symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2889-0","type":"journal-article","created":{"date-parts":[[2014,12,1]],"date-time":"2014-12-01T19:17:29Z","timestamp":1417461449000},"page":"981-996","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Laparoscopic Anterior Versus Posterior Fundoplication for Gastro\u2010esophageal Reflux Disease: A Meta\u2010analysis and Systematic Review"],"prefix":"10.1002","volume":"39","author":[{"given":"Muhammed Ashraf","family":"Memon","sequence":"first","affiliation":[{"name":"Sunnybank Obesity Centre, Suite 9, McCullough Centre 259 McCullough Street 4109 Sunnybank QLD Australia"},{"name":"School of Medicine, Mayne Medical School University of Queensland Brisbane QLD Australia"},{"name":"Faculty of Health Sciences and Medicine Bond University Gold Coast QLD 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