Effectiveness of laparoscopic total and partial fundoplication on extraesophageal manifestations of gastroesophageal reflux disease: a randomized study

Surg Laparosc Endosc Percutan Tech. 2012 Oct;22(5):387-91. doi: 10.1097/SLE.0b013e31825efb5b.


The aim of the present study was to evaluate the clinical effect of partial and total fundoplication on extraesophageal symptoms in a selected cohort of patients with gastroesophageal reflux disease (GERD). Hundred patients with documented GERD were randomized to either undergo floppy Nissen (n = 50) or Toupet fundoplication (n = 50). Symptom scores of cough, asthma, hoarseness, and distortion of taste were prospectively evaluated using a standardized symptom questionnaire before surgery and at 3- and 12-month follow-up. Statistical significance was set at a P-value of 0.05. All evaluated symptoms exhibited substantial improvement after Nissen fundoplication at 3- and 12-month follow-up. Similar therapeutic results were documented for Toupet fundoplication, although statistical significance could not be reached for asthma at long-term follow-up. In conclusion, the application of laparoscopic fundoplication is justified for patients with documented GERD and atypical symptoms refractory to medical treatment. Toupet fundoplication may have a lesser effect on asthma.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Fundoplication / methods*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Prospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome