Analysis Of Efficacy Of Nissen Vs. Dor Fundoplication In Treatment Of Gastroesophageal Reflux Disease

Objective: Gastroesophageal reflux disease(GERD)is a common disease in China.Nissen and Dor laparoscopic fundoplication are often used to treat GERD in patients who meet the surgical indications.In this study,Meta-analysis was used to evaluate these two surgical methods in controlling reflux symptoms,surgical safety and postoperative dysphagia,and patient satisfaction.In order to provide evidence-based medical evidence for the selection of surgical methods for GERD.Methods: All literatures that met the specific inclusion and exclusion criteria were collected by searching global authoritative public databases(Pub Med,Cochrane Library,Web of Science,CNKI database,Wanfang database,VIP database,etc.).MATA analysis was used to compare gastroesophageal reflux symptoms and other complications after laparoscopic Nissen and Dor surgery.The primary statistical indicator was postoperative complications after gastroesophageal reflux surgery.Literature was searched until February 1,2023.All search results met the inclusion criteria and exclusion criteria,and study quality evaluation and data extraction were performed.Meta-analysis was performed using Review Manager 5.4 statistical software.Results: Three randomized controlled trials and eight cohort studies with a total of 1161 patients were included,of which 704 patients underwent laparoscopic Nissen surgery and 457 patients underwent laparoscopic Dor surgery.Meta-analysis showed that laparoscopic Dor group was significantly better than Nissen group in postoperative dysphagia,postoperative flatulence,and postoperative reoperation for esophageal stricture;Nissen procedure was better than Dor procedure in gastroesophageal reflux recurrence symptoms;heterogeneity could not be discharged in average operation time and intraoperative blood loss,and there was no statistical significance in other indicators.Conclusion: Compared with laparoscopic Nissen operation,laparoscopic Dor operation has fewer complications in the surgical treatment of gastroesophageal reflux disease,but Dor operation is more likely to have recurrence of gastroesophageal reflux symptoms than Nissen operation.