{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:57:26Z","timestamp":1789732646855,"version":"4.0.1"},"reference-count":42,"publisher":"Royal College of Surgeons of England","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> Laparoscopic fundoplication remains the standard treatment for patients with severe gastro-oesophageal reflux disease (GORD). Multiple randomised controlled trials (RCTs) have compared the two most commonly performed surgical techniques, total and posterior partial fundoplication (Nissen [NF] and Toupet [TF]), in terms of symptom control and treatment failure in patients without subsequent dysmotility disorders. We aimed to conduct a systematic review and meta-analysis of these two techniques with regard to the long-term effect on reflux control and associated dysphagia. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> The MEDLINE<jats:sup>\u00ae<\/jats:sup>, Embase<jats:sup>\u00ae<\/jats:sup>, PubMed<jats:sup>\u00ae<\/jats:sup> and Cochrane Library databases were searched, and all the relevant published RCTs were shortlisted according to the inclusion criteria. The summated outcomes of long-term results relating to the recurrence of GORD and dysphagia were evaluated in a meta-analysis using RevMan software. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Eight studies (all RCTs) on 1,545 patients undergoing NF or TF were eligible for inclusion in this meta-analysis. There were 799 patients in the NF group and 746 in the TF group. In the random effects model analysis, the incidence of long-term recurrence of GORD was not statistically different between the NF and TF cohorts (odds ratio [OR]: 0.69, 95% confidence interval [CI]: 0.34\u20131.41, z=1.01, p=0.31). However, the incidence of long-term dysphagia was statistically lower in the TF group (OR: 2.92, 95% CI: 1.49\u20135.72, z=3.13, p=0.002) with low between-study heterogeneity (I<jats:sup>2<\/jats:sup>=0%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> The findings of this systematic review and meta-analysis on symptomatic GORD appear to be in favour of partial posterior fundoplication (TF) as the optimal treatment. It provides equivalent outcomes in reflux symptom control with a lower risk of postoperative dysphagia compared with total fundoplication (NF). <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2023.0046","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T12:36:30Z","timestamp":1697459790000},"page":"569-575","source":"Crossref","is-referenced-by-count":10,"title":["Long-term efficacy of total versus posterior partial fundoplication in patients with gastro-oesophageal reflux disease: a systematic review and meta-analysis"],"prefix":"10.1308","volume":"106","author":[{"given":"DV","family":"Peristeri","sequence":"first","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Room","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Tsironis","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Vasilikostas","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Wan","sequence":"additional","affiliation":[{"name":"St George\u2019s University Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"C1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00630.x"},{"key":"C2","unstructured":"British National Formulary. 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