The aim of the present study was to evaluate the clinical effect of partial and total fundoplication on extraesophageal symptoms in a selected cohort of patients with gastroesophageal reflux disease (GERD). Hundred patients with documented GERD were randomized to either undergo floppy Nissen (n = 50) or Toupet fundoplication (n = 50). Symptom scores of cough, asthma, hoarseness, and distortion of taste were prospectively evaluated using a standardized symptom questionnaire before surgery and at 3- and 12-month follow-up. Statistical significance was set at a P-value of 0.05. All evaluated symptoms exhibited substantial improvement after Nissen fundoplication at 3- and 12-month follow-up. Similar therapeutic results were documented for Toupet fundoplication, although statistical significance could not be reached for asthma at long-term follow-up. In conclusion, the application of laparoscopic fundoplication is justified for patients with documented GERD and atypical symptoms refractory to medical treatment. Toupet fundoplication may have a lesser effect on asthma.
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Article Synopsis
- * Surgical options for repairing HH include open surgery, various laparoscopic methods, transoral incisionless fundoplication, and magnetic sphincter augmentation (MSA), with laparoscopic Nissen fundoplication being the preferred standard treatment for GERD-related HH.
- * Newer treatments, like the MSA system and mesh repair, are designed to tailor procedures to individual patients for improved results, as reviewed by current literature from 2014 to 2024.
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