{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:54:14Z","timestamp":1782975254808,"version":"3.54.5"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002352","name":"Ain Shams University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastro-esophageal reflux disease (GERD) impairs quality of life and may require surgery when medical treatment fails. Laparoscopic Nissen fundoplication (LNF) is the traditional gold-standard, whereas laparoscopic Toupet fundoplication (LTF) may provide comparable reflux control with fewer motility-related side-effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center, parallel-group, randomized controlled trial (ClinicalTrials.gov identifier: NCT05432109) at Ain Shams University Hospitals. Twenty adults with medically refractory GERD were randomized (1:1) to LNF or LTF. Primary outcome was change in lower esophageal sphincter (LES) pressure measured by high-resolution manometry (HRM) 6\u00a0weeks post-operatively. Secondary outcomes included distal contractile integral (DCI), largest break size, distal latency (DL), hiatus hernia resolution, GERD Health-Related Quality of Life (GERD-HRQL) score, and adverse events. Analyses followed CONSORT guidelines and utilized an intention-to-treat approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both procedures significantly increased median LES pressure (LNF:\u2009+\u200912\u00a0mmHg; LTF:\u2009+\u200910\u00a0mmHg, p\u2009&lt;\u20090.001 each). LTF produced greater improvement in largest break size (\u2212\u20091.60\u00a0cm vs.\u2009\u2212\u20091.00\u00a0cm; p\u2009=\u20090.013) and GERD-HRQL (median reduction\u2009\u2212\u20093 vs.\u2009\u2212\u20092; p\u2009=\u20090.019). DCI rose more after LTF (+\u2009710 vs.\u2009+\u2009225\u00a0mmHg\u00a0s\u00a0cm; p\u2009=\u20090.051). Early dysphagia occurred in 40% of LNF versus 10% of LTF patients, while gas-bloat syndrome occurred in 30% vs. 0% (p\u2009=\u20090.07 and 0.04, respectively). No serious adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LTF provided equivalent reflux control, superior motility preservation, and fewer early obstructive symptoms compared with LNF. LTF should be considered the preferred anti-reflux procedure, particularly in patients with borderline esophageal motility. Larger multicenter trials with longer follow-up are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12112-6","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T16:20:56Z","timestamp":1756225256000},"page":"7281-7291","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative study between the effect of Nissen fundoplication and Toupet fundoplication on postoperative manometry findings. A randomized control trial study"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7119-8045","authenticated-orcid":false,"given":"Edward Atef Youssef","family":"Gadalla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ezzat","family":"el Serafy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman Hossam","family":"El din abd El Monaem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enaam Ali","family":"El Sayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf Kamal Mohamad","family":"Abdalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"issue":"3","key":"12112_CR1","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1111\/j.1572-0241.2001.03598.x","volume":"96","author":"D Sifrim","year":"2001","unstructured":"Sifrim D, Holloway R, Silny J et al (2001) Composition of the postprandial refluxate in patients with gastroesophageal reflux disease. Am J Gastroenterol 96(3):647\u2013655","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"12112_CR2","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1136\/gutjnl-2020-321365","volume":"70","author":"LH Eusebi","year":"2021","unstructured":"Eusebi LH, Cirota GG, Zagari RM et al (2021) Global prevalence of Barrett\u2019s esophagus and esophageal cancer in individuals with gastro-esophageal reflux: a systematic review and meta-analysis. Gut 70(3):456\u2013463","journal-title":"Gut"},{"key":"12112_CR3","volume-title":"UpToDate","author":"SJ Spechler","year":"2023","unstructured":"Spechler SJ (2023) Barrett\u2019s esophagus: surveillance and management. In: Post TW (ed) UpToDate. UpToDate Inc., Waltham"},{"key":"12112_CR4","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1007\/s11605-012-2074-4","volume":"17","author":"BE Louie","year":"2013","unstructured":"Louie BE, Kapur S, Blitz M et al (2013) Length and pressure of the reconstructed lower esophageal sphincter is determined by both crural closure and Nissen fundoplication. J Gastrointest Surg 17:236\u2013243","journal-title":"J Gastrointest Surg"},{"key":"12112_CR5","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/S1091-255X(02)00037-9","volume":"6","author":"C Hagedorn","year":"2002","unstructured":"Hagedorn C, L\u00f6nroth H, Rydberg L et al (2002) Long-term efficacy of total (Nissen\u2013Rossetti) and posterior partial (Toupet) fundoplication: results of a randomized clinical trial. J Gastrointest Surg 6:540\u2013545","journal-title":"J Gastrointest Surg"},{"key":"12112_CR6","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1053\/j.gastro.2010.10.010","volume":"140","author":"Y Jiang","year":"2011","unstructured":"Jiang Y, Sandler B, Bhargava V et al (2011) Antireflux action of Nissen fundoplication and stretch-sensitive mechanism of lower esophageal sphincter relaxation. Gastroenterology 140:442\u2013449","journal-title":"Gastroenterology"},{"key":"12112_CR7","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1136\/gutjnl-2017-314722","volume":"67","author":"CP Gyawali","year":"2018","unstructured":"Gyawali CP, Kahrilas PJ, Savarino E et al (2018) Modern diagnosis of GERD: the Lyon consensus. 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Lancet Gastroenterol Hepatol 8:237\u2013246","journal-title":"Lancet Gastroenterol Hepatol"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12112-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-12112-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12112-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:36:35Z","timestamp":1763145395000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-12112-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["12112"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-12112-6","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]},"assertion":[{"value":"29 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr. Edward Atef Youssef Gadalla, Prof. Mohamed Ezzat El Serafy, Dr. Ayman Hossam El Din Abd El Monaem, Dr. Enaam Ali El Sayed, and Prof. Ashraf Kamal Mohammad Abdella have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"Approved by the Ain Shams Faculty of Medicine Research Ethics Committee (FMASUSURG2122022).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}