Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/121410
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Long-term follow-up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication
Author: Hopkins, R.
Irvine, T.
Jamieson, G.
Devitt, P.
Watson, D.
Citation: The British journal of surgery, 2020; 107(1):56-63
Publisher: BJS Society
Issue Date: 2020
ISSN: 0007-1323
1365-2168
Statement of
Responsibility: 
R. J. Hopkins, T. Irvine, G. G. Jamieson, P. G. Devitt, D. I. Watson
Abstract: BACKGROUND:The side-effects of Nissen fundoplication have led to modifications, including partial fundoplications such as an anterior 90° wrap. Five-year follow-up of two randomized trials suggested fewer side-effects following anterior 90° partial fundoplication, but better reflux control after Nissen fundoplication. However, longer-term outcomes have not been reported. This study combined data from previous trials to determine 10-year outcomes. METHODS:From 1999 to 2003, 191 patients were enrolled in two randomized trials comparing anterior 90° partial versus Nissen fundoplication. Trial protocols were similar, and data were combined to determine long-term clinical outcomes. Patients completed annual questionnaires assessing dysphagia, heartburn, medications, satisfaction and other symptoms. Visual analogue scales (0-10), a composite dysphagia score (0-45) and yes/no responses were used. RESULTS:Of the 191 patients, 152 (79·6 per cent) were available for 10-year follow-up. After anterior 90° fundoplication, patients reported less dysphagia to solids (score 2·03 versus 3·18 for the Nissen procedure; P = 0·037). Heartburn scores were lower after Nissen fundoplication (1·90 versus 2·83 for anterior 90° fundoplication; P = 0·035) and fewer patients required proton pump inhibitors (PPIs) (22 versus 39 per cent respectively; P = 0·035). Satisfaction scores were similar for both anterior 90° and Nissen groups (7·45 versus 7·36 respectively; P = 0·566), and the majority considered their original decision for surgery to be correct (86 versus 84 per cent; P = 0·818). CONCLUSION:After 10 years, both procedures achieved similar success as measured by global satisfaction measures. Patients who had a Nissen fundoplication reported more dysphagia, whereas more heartburn and PPI consumption were reported after anterior 90° fundoplication. Registration numbers: ACTRN12607000298415 and ACTRN12607000304437 (http://www.anzctr.org.au/).
Keywords: Humans; Gastroesophageal Reflux; Postoperative Complications; Laparoscopy; Treatment Outcome; Fundoplication; Follow-Up Studies; Adult; Middle Aged; Patient Satisfaction; Female; Male
Description: First published: 10 September 2019
Rights: © 2019 BJS Society Ltd Published by John Wiley & Sons Ltd.
RMID: 1000000224
DOI: 10.1002/bjs.11327
Grant ID: http://purl.org/au-research/grants/nhmrc/157986
http://purl.org/au-research/grants/nhmrc/1022722
http://purl.org/au-research/grants/nhmrc/375111
Appears in Collections:Medicine publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.