A Clinical Comparison Of Laparoscopic Toupet And Dor Fundoplication For Gastroesophageal Reflux Disease

Objective:To comparison of the advantages and disadvantages of laparoscopic Toupet and Dor fundoplication in the treatment of hiatal hernia combined with gastroesophageal reflux disease. Methods:Statistical analysis 276 patients of GERD in our hospital from December 2012 to January 2015,149 patients undeiwent laparoscopic Nissen fundoplication,and 41 underwent laparoscopic laparoscopic Toupet fundoplication. 86patients underwent laparoscopic laparoscopic Dor fundoplication. Statistics three groups of patients with esophageal manometry,24-hour esophageal PH monitoring, GRED Q rating scale data and postoperative complications.In Nissen set of data as a standard control,differences between the two groups of related data. Results:There is no significant difference in surgery effect between the two surgical anti-reflux, there is no statistically significant difference in reflux time, acid reflux time percentage, DeMeester score,LES pressure (resting breathing minimum), residual pressure (maximum) and the internal pressure of the bolus (P> 0.05), But Dor group is better than Toupet group in reducing the number of reflux episodes and suppressed the long-reflux,the difference was statistically significant (P＜0.05). Toupet group were compared with the preoperative swallowing invalid increase and higher than the Nissen group and Dor group, the difference was statistically significant (P＜0.05). Toupet postoperative dysphagia (3 cases (7.31%)) is higher than the Nissen group (9 cases (6.04%)) and Dor group (2 cases (2.24%)).Follow-up 12-51 months (median 19 months). Conclusion:laparoscopic Dor fundoplication is better than Toupet fundoplication in reducing the number of reflux episodes and suppressed the long-reflux and increase LES pressure (mean resting respiration) and the incidence of postoperative dysphagia. But there is no significant difference between the two groups in overall anti-reflux effect.