Evidence map›Paper›PMID 31628621›Full record

SynthesisSurgical endoscopy2020

Assessing the efficacy and safety of laparoscopic antireflux procedures for the management of gastroesophageal reflux disease: a systematic review with network meta-analysis.

Alexandros Andreou, David I Watson, Dimitrios Mavridis, Nader K Francis, Stavros A Antoniou

Abstract readComparative StudySystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  10. 3D mesh-augmented hiatal hernia repair in patients with GERD: A 3-year single-center experience.Hernia : the journal of hernias and abdominal wall surgery · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexandros AndreouUpper GI Department, Castle Hill Hospital, Hull and East Yorkshire Hospitals NHS Foundation Trust, Hull, UK.
David I WatsonFlinders University Discipline of Surgery, Flinders Medical Centre, Bedford Park, Australia.
Dimitrios MavridisDepartment of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.
Nader K FrancisDepartment of General Surgery, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK.
Stavros A AntoniouDepartment of Surgery, European University Cyprus, Nicosia, Cyprus. stavros.antoniou@hotmail.com.ORCID 0000-0002-4630-6748

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the extensive literature on laparoscopic antireflux surgery, comparative evidence across different procedures is scarce. The aim of this study was to assess and rank the most efficacious and safe laparoscopic procedures for the management of gastroesophageal reflux disease.

methodsMedline, Embase, AMED, CINAHL, CENTRAL, and OpenGrey databases were queried for randomized trials comparing two or more laparoscopic antireflux procedures with each other or with medical treatment for the management of gastroesophageal reflux disease. Pairwise meta-analyses were conducted for each pair of interventions using a random-effects model. Network meta-analysis was employed to assess the relative efficacy and safety of laparoscopic antireflux procedures for the management of gastroesophageal reflux disease.

resultsForty-four publications reporting 29 randomized trials which included 1892 patients were identified. The network of treatments was sparse with only a closed loop between different types of wraps; 270°, 360°, anterior 180° and anterior 90°; and star network between 360° and other treatments; and between anterior 180° and other treatments. Laparoscopic 270° (odds ratio, OR 1.19, 95% confidence interval, CI 0.64-2.22), anterior 180°, and anterior 90° were equally effective as 360° for control of heartburn, although this finding was supported by low quality of evidence according to GRADE modification for NMA. The odds for dysphagia were lower after 270° (OR 0.38, 95%, CI 0.24-0.60), anterior 90° (moderate quality evidence), and anterior 180° (low-quality evidence) compared to 360°. The odds for gas-bloat were lower after 270° (OR 0.51, 95% CI 0.27, 0.95) and after anterior 90° compared to 360° (low-quality evidence). Regurgitation, morbidity, and reoperation were similar across treatments, albeit these were associated with very low-quality evidence.

conclusionLaparoscopic 270° fundoplication achieves a better outcome than 360° total fundoplication, especially in terms of postoperative dysphagia, although other types of partial fundoplication might be equally effective. REGISTRATION NO: CRD42017074783.

Indexed as

FundoplicationGastroesophageal RefluxLaparoscopyPatient SafetyDeglutition DisordersEsophagoplastyHeartburnHumansOdds RatioPostoperative ComplicationsRandomized Controlled Trials as TopicSecond-Look SurgeryTreatment OutcomeAntireflux surgeryFundoplicationGERDNetwork meta-analysis

Identifiers

PMID31628621

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.