J Gastrointest Surg (2014) 18:1077–1086 DOI 10.1007/s11605-014-2492-6
ORIGINAL ARTICLE
Short- and Long-Term Results of Laparoscopic Versus Open Anti-Reflux Surgery: a Systematic Review and Meta-Analysis of Randomized Controlled Trials Hui Qu & Yao Liu & Qing-si He
Received: 5 January 2014 / Accepted: 27 February 2014 / Published online: 14 March 2014 # 2014 The Society for Surgery of the Alimentary Tract
Abstract Background There is an ongoing debate about whether laparoscopic anti-reflux surgery (LARS) or open anti-reflux surgery (OARS) is the better option for the surgical treatment of gastroesophageal reflux disease (GERD). This study was aimed to evaluate and compare the short- and long-term results of both surgical strategies by means of a systematic review and metaanalysis. Methods A systematic search of electronic databases (PubMed, Embase, The Cochrane Library) for studies published from 1970 to 2013 was performed. All randomized controlled trials (RCTs) that compared LARS with OARS were included. We analyzed the outcomes of each type of surgery over short- and long-term periods. Results Twelve studies met final inclusion criteria (total n=1,067). A total of 510 patients underwent OARS and 557 had LARS. The pooled analyses showed, despite of longer operation time, the hospital stay and sick leave were significantly reduced in the LARS group. Significant reductions were also observed in complication rates for the LARS group in both short (odds ratio (OR) 0.31, 95 % CI 0.17 to 0.56) and long-term periods (OR 0.24, 95 % CI 0.07 to 0.80). Although complaints of reflux symptoms were more frequent among LARS patients in the short-term follow-up, LARS achieved better control of reflux symptoms in the long-term period (P0.05). Conclusions LARS is an effective and safe alternative of OARS for the surgical treatment of GERD, which enables a faster convalescence, better control of long-term reflux symptoms, and with reduced risk of complications. Keywords Gastroesophageal reflux disease . Laparoscopic anti-reflux surgery . Open anti-reflux surgery
Introduction Anti-reflux surgery is the treatment of choice for moderate to severe gastroesophageal reflux disease (GERD), particularly in patients with reflux symptoms that have not responded fully to medical therapy or who do not wish to continue medication H. Qu : Q.
ORIGINAL ARTICLE
Short- and Long-Term Results of Laparoscopic Versus Open Anti-Reflux Surgery: a Systematic Review and Meta-Analysis of Randomized Controlled Trials Hui Qu & Yao Liu & Qing-si He
Received: 5 January 2014 / Accepted: 27 February 2014 / Published online: 14 March 2014 # 2014 The Society for Surgery of the Alimentary Tract
Abstract Background There is an ongoing debate about whether laparoscopic anti-reflux surgery (LARS) or open anti-reflux surgery (OARS) is the better option for the surgical treatment of gastroesophageal reflux disease (GERD). This study was aimed to evaluate and compare the short- and long-term results of both surgical strategies by means of a systematic review and metaanalysis. Methods A systematic search of electronic databases (PubMed, Embase, The Cochrane Library) for studies published from 1970 to 2013 was performed. All randomized controlled trials (RCTs) that compared LARS with OARS were included. We analyzed the outcomes of each type of surgery over short- and long-term periods. Results Twelve studies met final inclusion criteria (total n=1,067). A total of 510 patients underwent OARS and 557 had LARS. The pooled analyses showed, despite of longer operation time, the hospital stay and sick leave were significantly reduced in the LARS group. Significant reductions were also observed in complication rates for the LARS group in both short (odds ratio (OR) 0.31, 95 % CI 0.17 to 0.56) and long-term periods (OR 0.24, 95 % CI 0.07 to 0.80). Although complaints of reflux symptoms were more frequent among LARS patients in the short-term follow-up, LARS achieved better control of reflux symptoms in the long-term period (P0.05). Conclusions LARS is an effective and safe alternative of OARS for the surgical treatment of GERD, which enables a faster convalescence, better control of long-term reflux symptoms, and with reduced risk of complications. Keywords Gastroesophageal reflux disease . Laparoscopic anti-reflux surgery . Open anti-reflux surgery
Introduction Anti-reflux surgery is the treatment of choice for moderate to severe gastroesophageal reflux disease (GERD), particularly in patients with reflux symptoms that have not responded fully to medical therapy or who do not wish to continue medication H. Qu : Q.
