Dor vs toupet fundoplication. J Gastrointest Surg 2018;22:13–22.

Dor vs toupet fundoplication Torres-Billalobos G, Coss-Adame E, Furuzawa-Carballeda J, et al. 689, 95% CrI 0. However, partial fundoplication has been advocated as providing similar reflux control while potentially minimizing dysphagia. Botulinum toxin's effect is The most commonly used procedure is the anterior partial fundoplication according to Dor, although during recent years the posterior counterpart (Toupet) has become popular. What is the difference between Partial and Nissen Fundoplication? In a Dor (anterior) partial fundoplication, the doctor will wrap the upper portion of the stomach halfway (180°) around the esophagus. May 22, 2020 · Torres-Villalobos G, et al. Pierce, Aurora Pryor, Valeria Martin, Margaret M. Jun 12, 2023 · Background In the surgical management of GERD, the traditional procedure is laparoscopic total (Nissen) fundoplication. 958). Nissen fundoplication (NF) is the most practiced, standardized and described since its early employments. From the 60 patients enrolled, 43 underwent 24-h A fundoplication causes compression of the GEJ by the plicated segment of gastric fund us. What to Expect During and After the Procedure On the other hand, Toupet supporters argue that the fundoplication helps to separate the borders of the myotomy and may provide better control of GER. 1. Classic symptoms Classic symptoms of GERD include burping, heartburn, chest pain, cough, or bad taste in the mouth and are caused by the contents In an attempt to mitigate the risk of persistent dysphagia following fundoplication, the original Nissen fundoplication has been modified to various partial fundoplication options such as the Dor and Toupet fundoplications, aiming to reduce the likelihood of creating an over-competent lower esophageal sphincter9, 10. Conclusions All three approaches of fundoplication share similar long-term outcomes, with the Toupet fundoplication likely Dor and Toupet groups were similar in age (46. pH studies at 6-12 months in 43 patients (72%: Dor n = 24 and Toupet n = 19) showed total DeMeester scores and % time pH<4 were not significant between the two groups. The traditional technique, however, is not easily reversible and the execution is variable. Patients who underwent Toupet fundoplication were not included in this study because there were too few cases during the study period to allow for meaningful analysis. The comparative outcomes of different approaches to fundoplication are a topic of ongoing debate and long-term outcomes remain uncertain. 95) mmHg vs. An upper GI contrast study is the main imaging technique for evaluation of postoperative fundoplication and its complications. doi: 10. 27% vs 2. Jun 14, 2023 · Thus, LHM with Dor fundoplication has the advantage of enabling a direct field of vision and allowing the tightness of the fundoplication to be adjusted, which might lower the risk of postoperative GERD. Failure of improvement with dilation suggests incomplete myotomy and requires repeat manometry. cpt 43280 , but technically the Dr did not state that, so should i go with a unlisted lap esoph code 43289 Partial Fundoplication. Robotic fundoplication is one of choice of Jun 14, 2023 · Thus, LHM with Dor fundoplication has the advantage of enabling a direct field of vision and allowing the tightness of the fundoplication to be adjusted, which might lower the risk of postoperative GERD. This study examined a simplified ‘‘3-stitch’’ Dor fundoplication that addressed these challenges and presented the results. As for conventional and laparoscopic approaches, Nissen, Toupet and Dor are the mainly performed techniques of fundoplication with the robotic surgery. Jun 3, 2020 · 8. However, multiple technical variations may account for the long-lasting reputation of decreased Aug 2, 2016 · Laparoscopic Nissen fundoplication (LNF) is the most common surgical procedure for the surgical management of gastro-esophageal reflux disease (GERD). A number of meta-analyses compared the efficacy of Sep 5, 2011 · Background Although symptom outcomes following laparoscopic fundoplication have been adequately evaluated in the past, comparative subjective data of laparoscopic Nissen and Toupet fundoplications are scarce. Feb 12, 2019 · Background and Aims Partial fundoplication is commonly performed in conjunction with Heller Myotomy. Use of the Toupet repair as a primary repair in patients with normal motility is controversial. The lack of specific investigations about robotic Toupet fundoplication (TF) and Dor fundoplication (DF) with relative data preclude to compare the three mentioned techniques accurately. Laparoscopic Toupet fundoplication (LTF) has been reported to have a lower prevalence of postoperative Early reports from Swanstrom report no pathologic reflux in 9 patients studied out of a cohort of 12. Vagal nerve injury is not higher with Dor fundoplication. From the 60 patients enrolled, 43 underwent 24-h pH Jan 1, 2020 · However, the choice of the partial fundoplication is debated. Fig. 8 were the first to randomize a total of 60 patients between Dor and Toupet after LHM. Laparoscopic Heller Myotomy (LHM) with partial fundoplication has become the treatment of choice for esophageal achalasia. Apr 25, 2019 · The choice of Dor vs. 001) and did not correlate with preoperative motility. Toupet fundoplication shows no significant difference in outcomes and is therefore left up to the surgeon's decision-making based on their individual experience [29]. 835) or between Dor and Nissen (OR 1. 13 A later study from Pellegrini and Pennings reported no significant differences between esophageal acid exposure times between Heller plus Dor (5. Toupet) in the literature, as the data are lacking and have mixed results , 16]. Aug 27, 2024 · The most likely indication for an open partial Toupet and Dor operation is when a laparoscopic approach is converted to an open one because of safety, adhesions, or complications. The preoperative Apr 1, 2022 · Nissen 360° posterior fundoplication; Toupet 270° posterior fundoplication; Dor 180-200° anterior fundoplication; Thal 270° anterior fundoplication; Radiographic features. There was no difference in severe dysphagia and reflux symptoms at 6 months and at the latest visit. Methods A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. pH studies at 6–12 months in 43 patients (72%: Dor n = 24 and Toupet n = 19) showed total DeMeester scores and % time pH \ 4 were not significant between the two groups. 00% vs 0. Slippage and recurrent hiatal hernia are not higher with Dor dysphagia than partial ones. Then fundoplication followed: either the Nissen or Toupet fundoplication as the standard fundoplication or modified Toupet fundoplication. Patients and methods: This is a systematic review and meta-analysis that evaluated the studies comparing between Nissen fundoplication and LTF for the treatment of GERD. pH studies at 6-12 months in 43 patients (72%: Dor n = 24 and Toupet n = 19) showed total DeMeester scores and % time pH < 4 were not significant between the two groups. Dec 13, 2016 · Major Finding: Dor fundoplication after laparoscopic Heller myotomy for achalasia was linked to a higher rate of abnormal reflux than was the Toupet approach, despite no symptomatic differences. MethodsA randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. Although not described in the original Toupet fundoplication, the medial part of the upper short gastric vessels is divided to create a fundoplication without undue circumferential tension around the distal esophagus. 22 The two most common partial laparoscopic fundoplication techniques include a 270-degree posterior (Toupet) fundoplication sutured to the crura and esophagus which creates a flap valve while leaving the anterior esophagus exposed to allow for radial expansion and a 180-degree anterior (Dor) fundoplication sutured to the esophagus and right dysphagia than partial ones. Methods: Patients with newly diagnosed achalasia and referred for cardiomyotomy were randomised to receive either an anterior or partial posterior fundoplication following May 19, 2023 · The illustration and description of the characteristic appearance of an anatomically intact Nissen fundoplication, Toupet fundoplication, Dor fundoplication, and Nissen fundoplication with Collis gastroplasty are shown in Figures 2 to 5, respectively. 8, 10 Rawlings et al. Authors offer no explanation for this observation. In fact, some authors reported poorer reflux control after LPPF than Nissen fundoplication at long-term follow-up, and it seems that the mechanical advantages of Toupet fundoplication tend to disappear with time (12,32,40-43). All adult patients undergoing elective laparoscopic repair of giant PEHs with Nissen (complete) or Dor (partial) fundoplication from January 2012 to December 2017 were included. Wright AS, Williams CW, Pellegrini CA, Oelschlager BK. Matthews, Carlos Pellegrini, Richard A. 072–2. 072-2. 11. 25±2. 05), while such results Sep 25, 2016 · The contrast in esophageal manometry between Toupet and Dor group showed that Dor group was better than Toupet group in the recovery of lower esophageal sphincter pressure (mean resting breathing) [(20. . Mar 17, 2024 · Introduction The debate continues as to whether laparoscopic total Nissen (LNF) versus partial posterior Toupet fundoplication (LTF) leads to better outcomes in the surgical treatment of axial hiatal hernia with gastroesophageal reflux disease. Hartwig, MD, MHS,a Durham, NC, and Riyadh, Saudi Arabia Video clip is available online. 06-0. 31 In 1963, A. Patient education: Gastroesophageal reflux disease in adults (Beyond the Basics) Approach to refractory gastroesophageal reflux disease in adults; Barrett's esophagus: Surveillance and management; Clinical manifestations and diagnosis of gastroesophageal reflux in adults Explore millions of resources from scholarly journals, books, newspapers, videos and more, on the ProQuest Platform. Methods One hundred patients with documented chronic gastroesophageal Mar 4, 2020 · Laparoscopic Toupet fundoplication has gained progressive consideration in the management of patients with gastroesophageal reflux disease and hiatus hernia. Sep 18, 2017 · However, the type of fundoplication is still a subject of debate. Therefore, the study analyses were based on 41 randomised patients (Dor, n = 19; Toupet, n = 22). Sep 18, 2017 · Methods: A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. pH studies at 6-12 months in 43 patients (72%: Dor n = 24 and Toupet n = 19) showed total Nov 5, 2020 · The choice of Dor vs. Jul 26, 2011 · Dor and Toupet groups were similar in age (46. However, for patients in whom esophageal peristalsis is documented to be weak preoperatively, use of a partial wrap, or Toupet procedure, has often bee … There were no dierences in dysphagia between Toupet and Dor (OR 0. Achalasia isan esophageal motordisorder that ischaracter-ized by failure of the lower esophageal sphincter (LES) to However, the type of fundoplication is still a subject of debate. 51. Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry. Prevents Worsening; Belsey Mark IV Repair. 001). Data Source: A multicenter, prospective, randomized, controlled trial comparing outcomes of Dor vs. Alternatively, anterior wraps where the stomach is passed anterior to the oesophagus such as the 180-200 degree Watson or Dor wraps. The dysphagia rates attributed to fundoplication range from 0% to 8%. The Nissen fundoplication is total (360°), but partial fundoplications known as Belsey fundoplication (270° anterior transthoracic), Dor fundoplication (anterior 180-200°) or Toupet fundoplication (posterior 270°) are also alternative procedures with somewhat different indications. 89) mmHg] and the decrease of ineffective swallowing [9. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and barium esophagogram. It is now timely to be re-evaluated and Fibbe C, Layer P, Keller J, et al. Laparoscopic esophagocardiomyotomy combined with partial fundoplication has become the preferred modality for the treatment of achalasia because of its consistent and durable palliation of dysphagia. Jan 1, 2018 · However, the choice of the partial fundoplication is debated. This randomized trial was conducted to compare Nissen's wrap and the anterior partial technique (Dor) concerning patients' quality of life (QoL) and functional data after a mid-term follow-up. (2002) Nissen vs Toupet laparoscopic fundoplication. In a Toupet (posterior) partial fundoplication, the doctor will wrap the upper portion of the stomach 3/4 of the way (270°) around the esophagus. We prospectively compared anterior fundoplication (Dor) with partial posterior fundoplication (Toupet) in patients undergoing laparoscopic Heller myotomy. The original 180-degree repair described by Andre Toupet has been modified and is usually a 270-degree or more fundoplication with crural Dec 15, 2023 · Methods: A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. 1 Adding a partial fundoplication, whether anterior or posterior, to Heller myotomy decreases the risk of esophageal reflux from approximately 50% without a fundoplication to less than 10% with a Mar 3, 2005 · The hypothesis that scarring between the fundoplication and esophageal mucosa in the anterior wrap may account for the poorer result after Dor procedure is also argued by Lyass. Toupet described the folding and anchoring of the gastric fundus posterior to the Results: No systematic discrepancy was found between the Nissen and Toupet fundoplication for any of the outcome parameters (intraoperative complications LNF 2. May 21, 2022 · The Heller myotomy with Dor fundoplication showed significant decrease in pathologic gastroesophageal reflux . Three studies met the inclusion criteria. Methods A multicenter, prospective, randomized-controlled trial was initiated to compare Dor versus Robotic Heller myotomy and Dor fundoplication: Twelve steps Suha Kaaki, MD,a,b and Matthew G. Previous studies showed equivalent results in terms of reflux control with lower rate of side effects compared to the Nissen fundoplication. Epub 2017 Sep 18. 23,24 The 270-degree partial fundoplication has been suggested to reduce the postoperative prevalence of dysphagia and gas related symptoms Jul 26, 2011 · Background The type of fundoplication that should be performed in conjunction with Heller myotomy for esophageal achalasia is controversial. Learn how the procedure can help. The Dor and Toupet antireflux procedures consist of partial anterior and posterior gastric fundoplication, respectively. 88%, postoperative complications 1. 7 years) and gender (52. Dor Fundoplication. Aim The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. Nissen fundoplication is usually considered as a contraindication in patients with achalasia because of the underlying esophageal aperistalsis. Dor and Toupet groups were similar in age (46. Network estimates demonstrated that Toupet had lower incidence of dysphagia compared to Nissen (OR 0. Jun 27, 2017 · The type of fundoplication has been a subject of debate until now. Multichannel intraluminal impedance monitoring (MII) has not been used so far for comparison of objective data. The great outcomes and minimal morbidity of the laparoscopic Heller myotomy with Dor fundoplication in esophageal centers have been widely reported [8] , [11] , including a report with Patient-reported symptoms and satisfaction did not vary for patients receiving laparoscopic Nissen versus Toupet fundoplication, which may indicate that patients with large type III and IV hiatal hernia undergoing either procedure have similar long-term postoperative symptom control. Sep 1, 2021 · Torres-Billalobos G, Coss-Adame E, Furuzawa-Carballeda J, Romero-Hernandez F, Blancas-Brena B, Torres-Landa S, et al. 44% vs 1. Temporarily, a 30-degree scope is used. Toupet fundoplication following laparoscopic Heller Robotic fundoplication is one of choice of treatment in minimally invasive surgical managements. 2018;22(1):13–22. 4%, respectively (P = 0. 15±6. The aim of this study was to compare outcomes for Dor and Toupet fundoplication after LHM. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and Teflon pledges. 8 vs. In the most recent meta-analysis including 13 RCTs with 1564 patients, no significant difference was found between the two procedures in terms of Fundoplication is a surgical procedure used to treat gastroesophageal reflux disease (GERD). In patients with inefficient esophageal motility, a partial fundoplication such as a Toupet 270-degree posterior fundoplication is often recommended. 2018;22:13–22. Results: Seventy-three patients were randomized, 38 underwent Dor and 35 Toupet. The aim was to perform a systematic review and meta-analysis of studies comparing these two procedures. 02) with similar reflux symptoms. 1-3 One therapeutic option for patients with GERD is daily intake of proton pump inhibitors (PPIs) to control symptoms and prevent the esophageal mucosa from reflux Sep 27, 2023 · - Nissen fundoplication - Toupet fundoplication; RELATED TOPICS. Apr 1, 2023 · Aim of the study: This study objected at comparing laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication (LTF) concerning the short-term and long-term outcomes. Frisella, Maria Cassera After 16 years, dysphagia score in the Toupet fundoplication group slightly increased to match that of the Nissen fundoplication group. Dysphagia was more frequent following a Nissen fundoplication than after a Toupet (30 vs 11, p <0. Dor vs Toupet fundoplication after laparoscopic Heller myotomy: Long-term randomized controlled trial evaluated by high-resolution manometry. Future studies A multicenter randomized controlled trial comparing these 2 approaches found a nonsignificant higher percentage of abnormal pH test results in 24 patients with Dor compared with 19 patients with Toupet fundoplication (41% vs 21%) with similar improvement of dysphagia and regurgitation symptoms in both groups . 473, 95% CrI 0. 1007/s11605-017-3578-8. It is, however, controversial whether anterior Dor or posterior Toupet partial fundoplication is the antireflux procedure of choice. Fundoplication Preformed Through a Thoracotomy Mn ; Anterior 240-Degrees; Potential Indications: Hostile Abdomen; Short Esophagus – Able to Its effectiveness in relieving dysphagia has been proven, but the lack of accompanying fundoplication predisposes to increased esophageal reflux. 62. Material and Methods A search of PubMed, Cochrane database Nissen and Toupet fundoplication are surgical anti-reflux procedures to treat Gastroesophageal Reflux Disease (GERD). Results: Interviews showed that 88% (Nissen) and 90% (Toupet) of the patients, respectively, were satisfied with the operative result. The Nissen fundoplication is the most popular laparoscopic operation performed for the surgical treatment of gastroesophageal reflux disease (GERD). A systematic search of r … A 180-degree anterior (Dor) fundoplication is usually paired with an esophagogastric myotomy in the surgical treatment of achalasia. The Nissen fundoplication, consisting of a total (360°) wrap, is the most commonly performed antireflux operation. More recently, Peroral Endoscopic Myotomy has competed for first-line therapy, but the postoperative GERD may be May 28, 2019 · In 1956, Nissen proposed the 360° fundoplication to control reflux in GER patients. 10% vs LTF 1. However, the choice of the partial fundoplication is debated. Preoperative and postoperative symptoms were evaluated with Eckardt, GERD-HRQL, and EAT-10 questionnaires. 2018 Jan;22(1):13-22. To reduce postoperative dysphagia and gas bloating, partial fundoplications are also used, including the posterior (Toupet) fundoplication, and the anterior (Dor) fundoplication. This was sent over with notes in box 19. This is the current “gold standard” for patients with GERD and normal esophageal motility. This is generally used for patients who have an abnormal esophageal function and may be at higher risk for difficulty swallowing (dysphagia) after surgery. Hello, A Dr I code for is stating that a Dor Fundoplication was performed, I tried googling it & everything pointed me to a nissen fundoplication. The authors are to be congratulated for a prospective long-term follow up analysis of two surgical techniques for treatment of acid reflux disease. Addition of an appropriate fundoplication procedure (Dor, Nissen, or Toupet techniques) is essential for improving the outcome of LHM. Oelschlager et al 48 compared Dor versus Toupet fundoplication along with an extended myotomy with the latter and found a higher incidence of postoperative dysphagia with Dor's fundoplication and suggested that this was due to the covering of the myotomy site with the wrap, which could lead to adhesion formation and recurrent obstruction. 44 vs. 9%) and Heller with Toupet fundoplication (6. 403-7. 14 Even though there have been several retrospective studies, to our knowledge, there are just two prospective randomized controlled trials comparing Dor vs Toupet fundoplication after LHM. (12. 0%), although 54% of the patients undergoing Heller Aug 9, 2021 · Achalasia is an esophageal motor disorder that is characterized by failure of the lower esophageal sphincter (LES) to relax and loss of peristalsis in the esophageal body. A systematic search of randomized controlled trials comparing Dor and Toupet fundoplication was performed using PubMed, EMBASE and Web of Science. This makes it easier to release pressure, such as the gas that builds up before a person burps. From here, it was determined that a fundoplication was necessary, but discussion remains on which type of fundoplication is ultimately best. We prefer the Dor fundoplication for straightforward achalasia and reserve Toupet Dec 15, 2023 · Introduction With the advent of the laparoscopic era in the 1990s, laparoscopic Heller myotomy replaced pneumatic dilation as the first-line treatment for achalasia. 30 In 1962, Dor described an anterior partial fundoplication procedure technique de Heller-Nissen modifiee covering the exposed mucosa at the area of the myotomy. (2001) Esophageal motility in reflux disease before and after fundoplication: a prospective, randomized, clinical, and manometric study. They differ in wrap construction both for the grades and for the anterior or posterior rotation. 69±13. Surg Endosc 16:758–766. 1 Treatment options focus on releasing the elevated pressure of the LES and include direct botulinum toxin injection, pneumatic dilation, per-oral endoscopic myotomy (POEM), and Heller myotomy. There is controversy … Jan 21, 2023 · Purpose We aim to review and quantitatively compare laparoscopic Toupet fundoplication (LTF), Nissen fundoplication (LNF), anterior partial fundoplication (APF), magnetic augmentation sphincter (MSA), radiofrequency ablation (RFA), transoral incisionless fundoplication (TIF), proton pump inhibitor (PPI), and placebo for the treatment of GERD. The risk of developing gastroesophageal reflux disease (GERD) increases with the severity of the anatomical changes and dysfunctions of the barrier against reflux of gastric contents through the esophagogastric junction (EGJ). The most commonly used partial fundoplications in clinical practice today are: the 180-degree anterior fundoplication and the 270-degree posterior fundoplication (also known as the Toupet fundoplication). Minimally invasive surgery has gained a role in the treatment of gastroesophageal reflux disease (GERD). An anterior 180° Dor fundoplication, a posterior 270° Toupet fundoplication, and a loose Nissen fundoplication have all been proposed. the type of fundoplication is still a subject of debate. A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. The wrap types can be split into posterior wraps where the stomach is wrapped behind the oesophagus. [Google Scholar] 28. Jan 1, 2021 · Request PDF | On Jan 1, 2021, Diego Coletta and others published Comparison between robotic Nissen, Toupet and Dor fundoplication: results | Find, read and cite all the research you need on Jun 2, 2021 · Partial fundoplication such as the Toupet posterior 270° and the Dor anterior 90° to 180° wraps were developed with the aim of providing long-term GERD control as with the successful Nissen fundoplication, but with reduced post-operative side effects such as dysphagia and gas bloat. May 13, 2024 · Fundoplication is a surgery for treating GERD, reflux-related symptoms, and hiatal hernias. 285; 95% CrI 0. One of the main claims against Toupet fundoplication is the uncertainty regarding the maintenance of its effects over time. Oelschlager compared Dor vs Toupet fundoplication following Heller myotomy reporting an incidence of recurrent achalasia of 17. It has been suggested that Nov 25, 2024 · Regardless, there is no clear evidence for one partial fundoplication over another (Dor vs. This study Sep 25, 2016 · The contrast in esophageal manometry between Toupet and Dor group showed that Dor group was better than Toupet group in the recovery of lower esophageal sphincter pressure (mean resting breathing) [(20. J Gastrointest Surg. 48%, general complications 2. AimThe aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. Two surgeons from our practice performed 43279,43659-51 The assistant surgeon was pd for 43279 but not for the unlisted 43659-51. Gastroenterology 121:5–14; Zornig C, Strate U, Fibbe C, et al. Although a Dor fundoplication is more commonly reported, the choice of Toupet vs Dor depends on surgeon preference. The three fundoplication types were comparable in all other outcomes. Torres-Villalobos G, Coss-Adame E, Furuzawa-Carballeda J, et al. There were no differences in dysphagia between Toupet and Dor (OR 0. Full-text for Emory users. Toupet fundoplication shows no significant difference in outcomes and is therefore left up to the surgeon’s decision-making based on their individual experience . A Toupet Fundoplication is a partial wrap of the stomach (usually described as a 270-degree wrap around the esophagus). 403–7. The difference is that Nissen is a complete, 360-degree wrap whereas Toupet is a 270-degree wrap. Soper, Brant Oelschlager, Lee Swanstrom, Brent D. Dec 30, 2018 · Toupet Fundoplication Print Section Listen The ideal therapy for gastroesophageal reflux disease (GERD) is a tailored approach with a short, floppy Nissen total fundoplication. Posterior 270-Degrees; Better if Concurrent Dysmotility. The procedure is now universally performed laparoscopically, and in majority of centers, in combination with a partial wrap as Dor , or Toupet fundoplication . A posterior wrap makes more sense to me to perform. 91±6. 18%, complication-related reoperation 1. Approach Mn . The hypothetical benefits of the Dor are a decreased risk of dysphagia and that the fundus covers part of the myotomy and buttresses it in case a small Laparoscopic Nissen fundoplication is currently the most commonly performed procedure for gastroesophageal reflux disease (GERD). Anterior 180-Degrees; Toupet Fundoplication. Health Conditions Toupet 270-degree posterior wrap: Laparoscopic Dor versus Toupet fundoplication following Heller myotomy for achalasia: Results of a multicenter, prospective, randomized-controlled trial Arthur Rawlings, Nathaniel J. An advantage of this approach was the addition of a fundoplication to reduce gastroesophageal reflux disease (GERD). Modified Toupet was carried out using two firm big bite retroesophageal fundo-crural stitches, the first approximately 1 cm from the angle of Hiss on the anterior aspect In recent years, several studies with large sample sizes and recent follow-up data have been published comparing outcomes between laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication. 3 Anterior (Dor) fundoplication following myotomy [ 42 ] Introduction: Fundoplication techniques for treatment of gastroesophageal reflux are discussed concerning impairments and success. 7,8,59 The only randomized controlled trial 21 comparing anterior vs posterior partial fundoplication showed a trend toward a higher Aug 26, 2024 · The primary indication for partial fundoplication is for reflux in patients with primary motility disorders. These include both the Nissen fundoplication and the 270-degree posterior Toupet wrap. Both involve the placement of a floppy, short wrap around the distal esophagus. Jul 8, 2020 · A comparison between the three techniques performed by a robotic-assisted approach of fundoplication, Nissen, Toupet and Dor, which seems to better control the GERD symptoms but has a higher rate of postoperative dysphagia than partial ones. 3% and 3. 8 were the first to randomize a total of 60 patients between Dor and Toupet after LHM. The most commonly performed fundoplications include the Nissen and Belsey Mark N (270-degree circumferential wraps), the Toupet (270-degree posterior wrap), and the Dor (180-degree anterior wrap). 55% Apr 1, 2022 · Nissen 360° posterior fundoplication; Toupet 270° posterior fundoplication; Dor 180-200° anterior fundoplication; Thal 270° anterior fundoplication; Radiographic features. 05), while such results Mar 31, 2022 · Toupet fundoplication This 270-degree wrap does not completely wrap around the base of the esophagus. Optimal length of the cardiomyotomy is at least 2 cm. The incidence of severe dysphagia at 1 month was less in the Dor group (0 of 48 vs 8 of 58, P = . The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and Jan 1, 2018 · Even though there have been several retrospective studies, to our knowledge, there are just two prospective randomized controlled trials comparing Dor vs Toupet fundoplication after LHM. 8, 10 Rawlings et al. 91%, recurrence on 1-year follow-up 6. 04](both P<0. Toupet Fundoplication. For details of the enrolment procedure, see Fig. Conclusion: Dor fundoplication is associated with less severe, early postoperative dysphagia. Mar 27, 2020 · 腹腔镜胃底折叠术式总体分为以360°Nissen胃底折叠全包绕（Total fundoplication）和以90°、180°（Dorfundoplication）、270°（Toupet fundoplication）部分包绕食管术式（Partial fundoplication），其中，部分包绕又分为以270°和180°食管后包绕（laparoscopic posterior fundoplication，LPF）和90 Dor and Toupet groups were similar in age (46. J Gastrointest Surg 2018;22:13–22. The Jul 1, 2014 · One patient allocated to a Dor fundoplication, ultimately decided to have pneumatic dilatation after randomisation, thus refusing surgery and was excluded from the trial. Dor vs Toupet fundoplication after laparosopic Heller myotomy: long-term randomized controlled trial evaluated by high-resolution manometry. 8,10 I personally prefer a Toupet fundoplication in this setting for the same reason I mentioned previously: gastric fundus is anatomically located posterior to esophagus. This maneuver also permits direct access to the retrogastric attachments, which are Even though there have been several retrospective studies, to our knowledge, there are just two prospective randomized controlled trials comparing Dor vs Toupet fundoplication after LHM. 699). 5% male). zclcqbs wdbsn tdv evpr aqr hohkd gpqd lqyhr yvxmsp cxapiz