Anterior Dor or posterior Toupet with Heller Myotomy for Achalasia Cardia: a systematic review and meta-analysis
Article
Article Title | Anterior Dor or posterior Toupet with Heller Myotomy for Achalasia Cardia: a systematic review and meta-analysis |
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ERA Journal ID | 16951 |
Article Category | Article |
Authors | Siddaiah-Subramanya, Manjunath (Author), Yunus, Rossita Mohamad (Author), Khan, Shahjahan (Author), Memon, Breda (Author) and Memon, Muhammed Ashraf (Author) |
Journal Title | World Journal of Surgery |
Journal Citation | 43 (6), pp. 1563-1570 |
Number of Pages | 8 |
Year | 2019 |
Place of Publication | United States |
ISSN | 0364-2313 |
1432-2323 | |
Digital Object Identifier (DOI) | https://doi.org/10.1007/s00268-019-04945-9 |
Web Address (URL) | https://link.springer.com/article/10.1007/s00268-019-04945-9 |
Abstract | Background and Aims: Partial fundoplication is commonly performed in conjunction with Heller Myotomy (HL). It is however controversial whether anterior Dor or posterior Toupet partial fundoplication is the anti-reflux procedure of choice. The aim was to perform a systematic review and meta-analysis of studies comparing these two procedures. Material and Methods: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, Google scholar and current contents for English language articles comparing Dor and Toupet fundoplication following HM between 1991 and 2018 was performed. The outcome variables analyzed included operating time, length of hospital stay (LOHS), overall complication rate, quality of life (QOL), postoperative reflux, residual postoperative dysphagia, treatment failure and reoperations. The meta-analysis was prepared in accordance with the PRISMA-P statement. Results: Seven studies totaling 486 patients (Dor = 245, Toupet = 241) were analyzed. LOHS was significantly shorter for Toupet repair compared to Dor procedure (WMD 0.73, 95% CI: 0.47 to 0.99; P <0.0001). Furthermore, patients after Toupet experienced significantly better QOL than those after Dor (WMD 1.68, 95% CI: 0.68 to 2.73, P < 0.001). All other variables showed comparable effects for these two procedures. Conclusion: Our systematic review and meta-analysis revealed that Toupet fundoplication is superior to Dor in terms of LOHS and QOL following HM. For other variables such as postoperative reflux, postoperative dysphagia, complication rates and treatment failure, both Dor and Toupet fundoplication produced effective and equivalent results. |
Keywords | Achalasia; Heller Cardiomyotomy; partial fundoplication; Dor fundoplication; Toupet fundoplication; laparoscopic method; comparative trials; randomized controlled trials; human |
ANZSRC Field of Research 2020 | 429999. Other health sciences not elsewhere classified |
490502. Biostatistics | |
Public Notes | File reproduced in accordance with the copyright policy of the publisher/author. |
Byline Affiliations | University of Queensland |
University of Malaya, Malaysia | |
School of Agricultural, Computational and Environmental Sciences | |
South East Queensland Surgery, Australia | |
Institution of Origin | University of Southern Queensland |
https://research.usq.edu.au/item/q501z/anterior-dor-or-posterior-toupet-with-heller-myotomy-for-achalasia-cardia-a-systematic-review-and-meta-analysis
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