SciELO - Scientific Electronic Library Online

vol.48 issue4Prospective study of bacteremia rate after elective band ligation and sclerotherapy with cyanoacrylate for esophageal varices in patients with advanced liver diseaseHelicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Arquivos de Gastroenterologia

Print version ISSN 0004-2803


RAMOS, Rodrigo F et al. Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis. Arq. Gastroenterol. [online]. 2011, vol.48, n.4, pp.252-260. ISSN 0004-2803.

CONTEXT: Although the high incidence of gastroesophageal reflux disease (GERD) in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. OBJECTIVE: To bring more clear evidence in the comparison between total and partial fundoplication. DATA SOURCES: A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration) was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. RESULTS: Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001) in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. CONCLUSION: The partial fundoplication has lower incidence of obstructive side effects.

Keywords : Gastroesophageal reflux; surgery; Fundoplication; Review; Meta-analysis.

        · abstract in Portuguese     · text in English     · English ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License