Does Toupet fundoplication provide better outcome after para-esophageal hernia repair?

Sweden: A new study published in the British Journal of Surgery showed that following para-oesophageal hernia (POH) repair, a partial posterior wrap (Toupet fundoplication) demonstrated fewer obstructive problems and enhanced quality of life compared to a total (Nissen) fundoplication.

Para-oesophageal hernia repair requires a fundoplication, although it's debatable whether that kind of fundoplication reduces postoperative mechanical difficulties. In order to examine the effectiveness of whole vs. partial posterior fundoplication in the surgical correction of para-esophageal hernias, Apostolos Analatos and colleagues undertook this study.

Between May 2009 and October 2018, a randomized, double-blind clinical experiment was undertaken. After hernia reduction and crural repair, a total of 70 patients with symptomatic POH were assigned to either a whole (Nissen) or a posterior partial (Toupet) fundoplication. At six months after surgery, dysphagia (measured by Ogilvie dysphagia scores) was the main result. The Dakkak dysphagia score, quality of life (QoL), peri- and postoperative problems, gastroesophageal reflux, peri- and postoperative complications, and radiologically verified hernia recurrence were secondary outcomes.