Evidence map›Paper›PMID 37438480›Full record

ArticleSurgical endoscopy2023

Laparoscopic Toupet fundoplication: a safe and effective anti-reflux option in lung transplant recipients.

Celeste G Yergin, Kelly M Herremans, Sheetal Patel, Andres Pelaez, Tiago N Machuca, Alexander L Ayzengart, Manuel A Amaris

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 13% of its field
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Safe and effective antireflux surgery in lung transplant recipients: preliminary results.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025
    Article
  3. Transoral incisionless fundoplication as rescue therapy for gastroesophageal reflux in a lung transplant recipient.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  4. Article
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

7 authors at 3 institutions in 1 country.

Celeste G YerginUniversity of Florida College of Medicine, Gainesville, FL, USA.ORCID 0000-0002-0070-3924
Kelly M HerremansUniversity of Florida College of Medicine, Gainesville, FL, USA.
Sheetal PatelUniversity of Florida College of Medicine, Gainesville, FL, USA.
Andres PelaezDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Tiago N MachucaDepartment of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Alexander L AyzengartAffiliate Community Faculty, University of Nevada, Reno, NV, USA.
Manuel A AmarisUniversity of Florida College of Medicine, Gainesville, FL, USA. Manuel.Amaris@medicine.ufl.edu.
University of Florida · USUniversity of Miami · USUniversity of Nevada, Reno · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFundoplication is known to improve allograft outcomes in lung transplant recipients by reducing retrograde aspiration secondary to gastroesophageal reflux disease, a modifiable risk factor for chronic allograft dysfunction. Laparoscopic Nissen fundoplication has historically been the anti-reflux procedure of choice, but the procedure is associated with discernable rates of postoperative dysphagia and gas-bloat syndrome. Laparoscopic Toupet fundoplication, an alternate anti-reflux surgery with lower rates of foregut complications in the general population, is the procedure of choice on our institution's lung transplant protocol. In this work, we evaluated the efficacy and safety of laparoscopic Toupet fundoplication in our lung transplant recipients.

methodsA prospective case series of 44 lung transplant recipients who underwent laparoscopic Toupet fundoplication by a single surgeon between September 2018 and November 2020 was performed. Preoperative and postoperative results from 24-h pH, esophageal manometry, gastric emptying, and pulmonary function studies were collected alongside severity of gastroesophageal reflux disease and other gastrointestinal symptoms.

resultsMedian DeMeester score decreased from 25.9 to 5.4 after fundoplication (p < 0.0001), while percentage of time pH < 4 decreased from 7 to 1.1% (p < 0.0001). The severity of heartburn and regurgitation were also reduced (p < 0.0001 and p = 0.0029 respectively). Overall, pulmonary function, esophageal motility, gastric emptying, severity of bloating, and dysphagia were not significantly different post-fundoplication than pre-fundoplication. Patients with decreasing rates of FEV1 pre-fundoplication saw improvement in their rate of change of FEV1 post-fundoplication (p = 0.011). Median follow-up was 32.2 months post-fundoplication.

conclusionsLaparoscopic Toupet fundoplication provides objective pathologic acid reflux control and symptomatic gastroesophageal reflux improvement in lung transplant recipients while preserving lung function and foregut motility. Thus, laparoscopic Toupet fundoplication is a safe and effective antireflux surgery alternative in lung transplant recipients.

Indexed as

Deglutition DisordersGastroesophageal RefluxLaparoscopyFundoplicationHumansLungPostoperative ComplicationsTransplant RecipientsTreatment OutcomeDysphagiaEsophageal motilityGERDLung transplantRegurgitationToupet fundoplication

Identifiers

PMID37438480
OpenAlexW4384028977

What OpenQuestion holds

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Registered trials

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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.