Comparative Study between Nissen Fundoplication and Toupet Fundoplication in Treatment of Hiatus Hernia in Patients with Refractory GERD in Terms of Efficacy and Adverse Outcomes

Background: The degree of anatomical abnormalities and dysfunctions of the barrier preventing stomach contents from refluxing across the esophagogastric junction raises the risk of progressing gastroesophageal reflux disease (GERD).
Aim: This study aimed to compare the long-term effectiveness of laparoscopic Toupet versus Nissen fundoplication for hiatal hernia management and adverse outcomes in Suez Canal University Hospital.
Patients and methods: This prospective comparative research has been performed on General Surgery Department, Suez Canal University Hospital Through the period from January 2022 to January 2024. Cases with GERD who are candidate for operation attending to the General Surgery Department, Suez Canal University Hospitals. The candidates have been divided into two groups (A and B), where group A had laparoscopic Nissen fundoplication and group B underwent laparoscopic Toupet fundoplication.
Results: There was a statistical insignificant variance among examined groups (Toupet vs. Nissen groups) as regards readmission, hernia recurrence, heart burn relief, regurge relief, chest pain relief, chest pain on eating, post prandial fullness, increased flatus, manometry (LES hypotensive), PH DeMeester score, esophagitis grade II and esophagitis grade III. There was a statistically significant variance among examined groups (Toupet and Nissen groups) as regards gas bloating
Conclusion: The study detected an insignificant variance between Toupet and Nissen fundoplication in controlling acid reflux, GERD symptoms, and improving quality of life. However, a significant difference in dysphagia scorings suggests Toupet fundoplication should be recommended before Nissen fundoplication for surgical GERD management.