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Is There a Role for Anything Other Than a Nissen’s Operation?

  • DeMeester Festschrift
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The Nissen fundoplication is the most frequently applied antireflux operation worldwide. The aim of this review was to compare laparoscopic Nissen with partial fundoplication.

Methods

Nine randomized trials comparing several types of wraps were analyzed, four for the comparison Nissen vs. Toupet and five for the comparison Toupet or Nissen vs. anterior fundoplication. Similar comparisons in nonrandomized studies were also included.

Results

Dysphagia rates and reflux recurrence were not related to preoperative esophageal persistalsis independent of the selected procedure. Overall, Nissen fundoplication revealed slightly better reflux control, but was associated with more side effects, such as early dysphagia and gas bloat. Advantages of an anterior approach were only reported by one group. A significantly higher reflux recurrence rate for anterior fundoplication was observed in all other comparisons.

Conclusion

Tailoring antireflux surgery according to esophageal motility is not indicated. At present, the relevant factor for selection of a Nissen or Toupet fundoplication is personal experience. Anterior fundoplication offers less effective long-term reflux control.

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Disclosure

The corresponding author declares that none of the authors has any connections whatsoever with the companies whose products are named in this paper or with any company in competition with those companies. The presentation of the topic is impartial and the contents are entirely product-neutral.

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  1. Chirurgische Klinik und Poliklinik I, Klinikum der Universität Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Germany

    Martin Fein & Florian Seyfried

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  1. Martin Fein
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  2. Florian Seyfried
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Correspondence to Martin Fein.

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Fein, M., Seyfried, F. Is There a Role for Anything Other Than a Nissen’s Operation?. J Gastrointest Surg 14 (Suppl 1), 67–74 (2010). https://doi.org/10.1007/s11605-009-1020-6

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  • DOI: https://doi.org/10.1007/s11605-009-1020-6

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