To compare the clinical efficacy of laparoscopic Nissen and Toupet fundoplication in the treatment of refractory gastroesophageal reflux disease.

132 patients with refractory gastroesophageal reflux disease treated by laparoscopic fundoplication in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were collected retrospectively. Sixty-eight patients undergoing laparoscopic Nissen fundoplication were selected as Nissen group, and 64 patients undergoing laparoscopic Toupet fundoplication were selected as Toupet group.The operation-related indexes, the results of high-resolution esophageal pressure measurement[lower esophageal sphincter pressure(LESP), Integrated relaxation pressure(IRP)], the results of 24-hour pH monitoring[DeMeester score, the number of reflux], GERD-Q score before and after 1 month of operation, the improvement of clinical symptoms after operation, and complications during postoperative hospitalization and 1 year afteroperation were compared between two groups.

The operation time of the Nissen group was shorter than that of the Toupet group(P<0.05). Compared with before operation, the LESP and IRP of the two group were higher than those after 1 month of operation(all P<0.05); the DeMeester score, the number of reflux and the GERD-Q score were lower than those after 1 month of operation (all P<0.05); while there was no statistical difference between the two group(all P>0.05). Compared with before operation, the scores of burning sensation, acid reflux, regurgitation, and chest pain of Nissen group and Toupet group were lower than those after 1 month of operation (all P<0.05) ; while there was no statistical difference between the two group(all P>0.05). During hospitalization, the incidence of dysphagia in the Nissen group was higher than that in the Toupet group(P<0.05) , After 1 year of operation, there was no difference between the two groups (P>0.05).

Laparoscopic Toupet and Nissen fundoplication have good curative effects in the treatment of refractory gastroesophageal reflux disease. Compared with the laparoscopic Toupet fundoplication, the laparoscopic Nissen fundoplication has a shorter operation time and a higher incidence of dysphagia in the short term after the operation. The incidence of long-term dysphagia is comparable.

Stomach; Esophagus; Reflux disease; Laparoscopy; Fundoplication