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01-10-2013 | Review Article

Complete Versus Partial Fundoplication in Children with Gastroesophageal Reflux Disease: Results of a Systematic Review and Meta-analysis

Authors: F. A. Mauritz, B. A. Blomberg, R. K. Stellato, D. C. van der Zee, P. D. Siersema, M. Y. A. van Herwaarden-Lindeboom

Published in: Journal of Gastrointestinal Surgery | Issue 10/2013

Abstract

Complete fundoplication (Nissen) has long been accepted as the gold standard surgical procedure in children with therapy-resistant gastroesophageal reflux disease (GERD); however, increasingly more evidence has become available for partial fundoplication as an alternative. The aim of this study was to perform a systematic review and meta-analysis comparing complete versus partial fundoplication in children with therapy-resistant GERD. PubMed (1960 to 2011), EMBASE (from 1980 to 2011), and the Cochrane Library (issue 3, 2011) were systematically searched according to the PRISMA statement. Results were pooled in meta-analyses and expressed as risk ratios (RRs). In total, eight original trials comparing complete to partial fundoplication were identified. Seven of these studies had a retrospective study design. Short-term (RR 0.64; p = 0.28) and long-term (RR 0.85; p = 0.42) postoperative reflux control was similar for complete and partial fundoplication. Complete fundoplication required significantly more endoscopic dilatations for severe dysphagia (RR 7.26; p = 0.007) than partial fundoplication. This systematic review and meta-analysis showed that reflux control is similar after both complete and partial fundoplication, while partial fundoplication significantly reduces the number of dilatations to treat severe dysphagia. However, because of the lack of a well-designed study, we have to be cautious in making definitive conclusions. To decide which type of fundoplication is the best practice in pediatric GERD patients, more randomized controlled trials comparing complete to partial fundoplication in children with GERD are warranted.

Sherman PM, Hassall E, Fagundes-Neto U, Gold BD, Kato S, Koletzko S et al. A global, evidence-based consensus on the definition of gastroesophageal reflux disease in the pediatric population. Am J Gastroenterol 2009; 104(5):1278–1295.PubMedCrossRef

Vandenplas Y, Rudolph CD, Di LC, Hassall E, Liptak G, Mazur L et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2009; 49(4):498–547.PubMedCrossRef

Hassall E. Outcomes of fundoplication: causes for concern, newer options. Arch Dis Child 2005; 90(10):1047–1052.PubMedCrossRef

Hassall E. Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children. J Pediatr 2005; 146(3 Suppl):S3-12.PubMed

Mauritz FA, van Herwaarden-Lindeboom MY, Stomp W, Zwaveling S, Fischer K, Houwen RH et al. The effects and efficacy of antireflux surgery in children with gastroesophageal reflux disease: a systematic review. J Gastrointest Surg 2011; 15(10):1872–1878.PubMedCrossRef

Di Lorenzo C, Orenstein S. Fundoplication: friend or foe? J Pediatr Gastroenterol Nutr 2002; 34(2):117–124.PubMedCrossRef

Fonkalsrud EW, Ashcraft KW, Coran AG, Ellis DG, Grosfeld JL, Tunell WP et al. Surgical treatment of gastroesophageal reflux in children: a combined hospital study of 7467 patients. Pediatrics 1998; 101(3 Pt 1):419–422.PubMedCrossRef

Kimber C, Kiely EM, Spitz L. The failure rate of surgery for gastro-oesophageal reflux. J Pediatr Surg 1998; 33(1):64–66.PubMedCrossRef

Esposito C, Montupet P, van Der Zee D, Settimi A, Paye-Jaouen A, Centonze A et al. Long-term outcome of laparoscopic Nissen, Toupet, and Thal antireflux procedures for neurologically normal children with gastroesophageal reflux disease. Surg Endosc 2006; 20(6):855–858.PubMedCrossRef

10.

Kubiak R, Andrews J, Grant HW. Long-term outcome of laparoscopic Nissen fundoplication compared with laparoscopic Thal fundoplication in children: a prospective, randomized study. Ann Surg 2011; 253(1):44–49.PubMedCrossRef

11.

Allal H, Captier G, Lopez M, Forgues D, Galifer RB. Evaluation of 142 consecutive laparoscopic fundoplications in children: effects of the learning curve and technical choice. J Pediatr Surg 2001; 36(6):921–926.PubMedCrossRef

12.

Weber TR. Toupet fundoplication for gastroesophageal reflux in childhood. Arch Surg 1999; 134(7):717–720.PubMedCrossRef

13.

Georgeson K. Laparoscopic fundoplication and gastrostomy. Seminars in Laparoscopic Surgery 1998; 5(1):25–30.PubMed

14.

Meehan JJ, Georgeson KE. Laparoscopic fundoplication in infants and children. Surg Endosc 1996; 10(12):1154–1157.PubMedCrossRef

15.

Meehan JJ, Georgeson KE. The learning curve associated with laparoscopic antireflux surgery in infants and children. J Pediatr Surg 1997; 32(3):426–429.PubMedCrossRef

16.

Broeders JA, Mauritz FA, Ahmed AU, Draaisma WA, Ruurda JP, Gooszen HG et al. Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease. Br J Surg 2010; 97(9):1318–1330.PubMedCrossRef

17.

Broeders JA, Roks DJ, Ahmed AU, Draaisma WA, Smout AJ, Hazebroek EJ. Laparoscopic anterior versus posterior fundoplication for gastroesophageal reflux disease: systematic review and meta-analysis of randomized clinical trials. Ann Surg 2011; 254(1):39–47.PubMedCrossRef

18.

Broeders JA, Bredenoord AJ, Hazebroek EJ, Broeders IA, Gooszen HG, Smout AJ. Reflux and belching after 270 degree versus 360 degree laparoscopic posterior fundoplication. Ann Surg 2012; 255(1):59–65.PubMedCrossRef

19.

Kubiak R, Andrews J, Grant HW. Laparoscopic Nissen fundoplication versus Thal fundoplication in children: comparison of short-term outcomes. J Laparoendosc Adv Surg Tech A 2010; 20(7):665–669.PubMedCrossRef

20.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med 2009; 3(3):e123–e130.PubMed

21.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6(7):e1000097.PubMedCrossRef

22.

Catarci M, Gentileschi P, Papi C, Carrara A, Marrese R, Gaspari AL et al. Evidence-based appraisal of antireflux fundoplication. Ann Surg 2004; 239(3):325–337.PubMedCrossRef

23.

Higgins J, Green S. Cochrane handbook for systematic reviews of interventions. Wiley: Chichester; 2008.CrossRef

24.

DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7(3):177–188.PubMedCrossRef

25.

DeMets DL. Methods for combining randomized clinical trials: strengths and limitations. Stat Med 1987; 6(3):341–350.PubMedCrossRef

26.

Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21(11):1539–1558.PubMedCrossRef

27.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414):557–560.PubMedCrossRef

28.

Egger M, Davey SG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109):629–634.PubMedCrossRef

29.

Bacewicz L, Kalicinski P, Drewniak T. [Manometric assessment of esophageal function in children with gastroesophageal reflux after various types of fundoplication]. Contemporary Pediatrics, Gastroenterology, Hepatology 2002; 4(2):135–139.

30.

Ceriati E, Guarino N, Zaccara A, Marchetti P, la Sala E, Lucchetti MC et al. Gastroesophageal reflux in neurologically impaired children: partial or total fundoplication? Langenbecks Arch Surg 1998; 383(5):317–319.PubMedCrossRef

31.

Goessler A, Huber-Zeyringer A, Hoellwarth ME. Recurrent gastroesophageal reflux in neurologically impaired patients after fundoplication. Acta Paediatr 2007; 96(1):87–93.PubMedCrossRef

32.

Kazerooni NL, VanCamp J, Hirschl RB, Drongowski RA, Coran AG. Fundoplication in 160 children under 2 years of age. J Pediatr Surg 1994; 29(5):677–681.PubMedCrossRef

33.

Strecker-McGraw MK, Lorenz ML, Hendrickson M, Jolley SG, Tunell WP. Persistent gastroesophageal reflux disease after antireflux surgery in children: I. Immediate postoperative evaluation using extended esophageal pH monitoring. J Pediatr Surg 1998; 33(11):1623–1627.PubMedCrossRef

34.

Wagener S, Sudhakaran N, Cusick E. Watson fundoplication in children: a comparative study with Nissen fundoplication. J Pediatr Surg 2007; 42(6):1098–1102.PubMedCrossRef

35.

Broeders JA, Sportel IG, Jamieson GG, Nijjar RS, Granchi N, Myers JC et al. Impact of ineffective oesophageal motility and wrap type on dysphagia after laparoscopic fundoplication. Br J Surg 2011; 98(10):1414–1421.PubMedCrossRef

36.

Strate U, Emmermann A, Fibbe C, Layer P, Zornig C. Laparoscopic fundoplication: Nissen versus Toupet two-year outcome of a prospective randomized study of 200 patients regarding preoperative esophageal motility. Surg Endosc 2008; 22(1):21–30.PubMedCrossRef

37.

Bais JE, Bartelsman JF, Bonjer HJ, Cuesta MA, Go PM, Klinkenberg-Knol EC et al. Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial. The Netherlands Antireflux Surgery Study Group. Lancet 2000; 355(9199):170–174.PubMedCrossRef

38.

Watson DI, Baigrie RJ, Jamieson GG. A learning curve for laparoscopic fundoplication. Definable, avoidable, or a waste of time? Ann Surg 1996; 224(2):198–203.PubMedCrossRef

39.

Capito C, Leclair MD, Piloquet H, Plattner V, Heloury Y, Podevin G. Long-term outcome of laparoscopic Nissen–Rossetti fundoplication for neurologically impaired and normal children. Surg Endosc 2008; 22(4):875–880.PubMedCrossRef

40.

Cheung KM, Tse HW, Tse PW, Chan KH. Nissen fundoplication and gastrostomy in severely neurologically impaired children with gastroesophageal reflux. Hong Kong Med J 2006; 12(4):282–288.PubMed

41.

Esposito C. Fundoplication: certainly a friend for children with GERD if the indication for surgery is correct. J Pediatr Gastroenterol Nutr 2003; 37(1):98–99.PubMedCrossRef

42.

Esposito C, De LC, Alicchio F, Giurin I, Miele E, Staiano AM et al. Long-term outcome of laparoscopic nissen procedure in pediatric patients with gastroesophageal reflux disease measured using the modified QPSG Roma III European Society for Pediatric Gastroenterology Hepatology and Nutrition's Questionnaire. J Laparoendosc Adv Surg Tech A 2011.

43.

McHoney M, Wade AM, Eaton S, Howard RF, Kiely EM, Drake DP et al. Clinical outcome of a randomized controlled blinded trial of open versus laparoscopic Nissen fundoplication in infants and children. Ann Surg 2011; 254(2):209–216.PubMedCrossRef

44.

Kane TD, Brown MF, Chen MK. Position paper on laparoscopic antireflux operations in infants and children for gastroesophageal reflux disease. American Pediatric Surgery Association. J Pediatr Surg 2009; 44(5):1034–1040.PubMedCrossRef

45.

Mattioli G, Repetto P, Carlini C, Torre M, Pini Prato A, Mazzola C et al. Laparoscopic vs open approach for the treatment of gastroesophageal reflux in children. Surg Endosc 2002; 16(5):750–752.PubMedCrossRef

46.

Siddiqui MR, Abdulaal Y, Nisar A, Ali H, Hasan F. A meta-analysis of outcomes after open and laparoscopic Nissen's fundoplication for gastro-oesophageal reflux disease in children. Pediatr Surg Int 2011; 27(4):359–366.PubMedCrossRef

Title: Complete Versus Partial Fundoplication in Children with Gastroesophageal Reflux Disease: Results of a Systematic Review and Meta-analysis
Authors: F. A. Mauritz
B. A. Blomberg
R. K. Stellato
D. C. van der Zee
P. D. Siersema
M. Y. A. van Herwaarden-Lindeboom
Publication date: 01-10-2013
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 10/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2305-3

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Complete Versus Partial Fundoplication in Children with Gastroesophageal Reflux Disease: Results of a Systematic Review and Meta-analysis

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