Laparoscopic fundoplication is the gold standard for the surgical treatment of gastroesophageal reflux disease.
In this study, researchers from Italy performed a systematic review of randomized controlled trials on laparoscopic and open antireflux surgery.
The team identified 41 papers relating to 25 randomized controlled trials, between 1974 and 2002.
The team performed a meta-analysis, pooling the results as odds ratios (OR), rate differences (RD), and number needed to treat (NNT).
|There were no perioperative deaths in any of the trials.|
|Annals of Surgery|
The researchers did not find any perioperative deaths in any of the trials.
They identified a lower operative morbidity rate (10% versus 27%), shorter postoperative stay (3.1 versus 5.2 days), and shorter sick leave (20.1 versus 35.8 days) for laparoscopic versus open fundoplication.
The team did not find any significant differences regarding the incidence of recurrence, dysphagia, bloating, and reoperation for failure at midterm follow-up.
They were unable to identify any differences in operative morbidity or operative time for partial versus total fundoplication.
Dr Marco Catarci's team concluded, "Laparoscopic antireflux surgery is at least as safe and as effective as its open counterpart, with reduced morbidity, shortened postoperative stay, and sick leave".
"Partial fundoplication significantly reduces the risk of reoperations for failure over total fundoplication".
"Routine versus no division of short gastric vessels showed no significant advantages".