Individualized approach in choosing the method of fundoplication

Introduction. A critical aspect of the surgical treatment of gastroesophageal reflux disease (GERD) and hiatal hernias is the selection of the antireflux surgical technique, which determines the success and long-term outcomes of the intervention. The utilization of manometry for assessing esophageal motility has become increasingly relevant, as it provides crucial data regarding peristaltic activity.

The purpose of the study. To analyze existing methods of antireflux reconstruction, evaluate their advantages and disadvantages, and determine the feasibility of applying different approaches based on the individual characteristics of patients, thereby improving the outcomes of surgical treatment for gastroesophageal reflux and enhancing patients' quality of life.

Materials and methods of research. Review of articles published in scientific databases such as PubMed, Web of Science, Scopus, and eLIBRARY.

Results of research. The study discusses the advantages and disadvantages of the Nissen, Chernousov, and Toupet techniques, as well as the importance of a personalized approach tailored to each patient, considering individual characteristics and the severity of the disease.

Conclusion. An individualized approach to the treatment of GERD and hiatal hernias, based on patients’ individual characteristics and disease severity, is critical for achieving optimal clinical outcomes and minimizing complications. It is essential to consider not only the effectiveness of treatment methods but also potential complications and long-term consequences for patients.

1. Starostin B.D. Contemporary approaches to the treatment of gastroesophageal reflux disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2019, № 29 (1), pp. 7–16. (In Russ.) https://doi.org/10.22416/1382-4376-2019-29-1-7-16

2. Gyawali C.P., Kahrilas P.J., Savarino E., Zerbib F., Mion F., Smout A.J.P.M., Vaezi M., Sifrim D., Fox M.R., Vela M.F., Tutuian R., Tack J., Bredenoord A.J., Pandolfino J., Roman S. Modern diagnosis of GERD. The Lyon Consensus, 2018, № 67 (7), pp. 1351–1362. https://doi.org/10.1136/gutjnl-2017-314722

3. Bakhos C.T., Petrov R.V., Parkman H.P., Malik Z., Abbas A.E. Role and safety of fundoplication in esophageal disease and dysmotility syndromes. Journal of thoracic disease, 2019, № 11, pp. 1610–1617. https://doi.org/10.21037/jtd.2019.06.62

4. Seo K.W., Park M.I., Yoon K.Y., Park S.J., Kim S.E. Laparoscopic partial fundoplication in case of gastroesophageal reflux disease patient with absent esophageal motility. Journal of gastric cancer, 2015, № 15 (2), pp. 127–131. https://doi.org/10.5230/jgc.2015.15.2.127

5. Burikov M.A., Skazkin I.V., Shulgin O.V., Kinyakin A.I., Sokirenko I.A. Long-term outcome of the laparoscopic repair of hiatus hernia. Clinical practice, 2018, № 9 (3), pp. 26–33. (In Russ.)

6. Galmiche J.P., Letessier E., Scarpignato C. Treatment of gastro-oesophageal reflux disease in adults. BMJ, 1998, № 316 (7146), pp. 1720–1723. https://doi.org/10.1136/bmj.316.7146.1720

7. Vasilevsky D.I., Kulagin V.I., Silantiev D.S., Bagnenko S.F. Choice of antireflux procedure in surgery of gastroesophageal reflux disease. Grekov’s Bulletin of Surgery, 2018, № 172 (5), pp. 26-29. (In Russ.)

8. Frazzoni M., Piccoli M., Conigliaro R., Frazzoni L., Melotti G. Laparoscopic fundoplication for gastroesophageal reflux disease. World journal of gastroenterology, 2014, № 20 (39), pp. 14272–14279. https://doi.org/10.3748/wjg.v20.i39.14272

9. Galliamov E.A., Agapov M.A., Lucevich O.E., Kubishkin V.A., Erin S.A., Presnov K.S., Busyrev Yu.B., Kakotkin V.V., Torosyan O.G. Laparoscopic correction of reccurence of gastroesophageal reflux disease and hernia of the esophageal aperture of the diaphragm. Surgical practice, 2019, № 3, pp. 33–40. (In Russ.). https://doi.org/10.38181/issn2223-2427.2019.3.33-40

10. Salminen P. The laparoscopic Nissen fundoplication – a better operation? The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, 2009, № 7 (4), рр. 224–227. https://doi.org/10.1016/s1479-666x(09)80089-9

11. Stefanidis D., Hope W.W., Kohn G.P., et al. Guidelines for surgical treatment of gastroesophageal reflux disease. Surg Endosc., 2010, № 24, pp. 2647–2669. https://doi.org/10.1007/s00464-010-1267-8

12. Riedl O., Gadenstätter M., Lechner W., Schwab G., Marker M., Ciovica R. Preoperative lower esophageal sphincter manometry data neither impact manifestations of GERD nor outcome after laparoscopic Nissen fundoplication. J Gastrointest Surg., 2009, № 13 (7), pp. 1189–1197. https://doi.org/10.1007/s11605-009-0890-y

13. Yurasov A.V., Bitarov T.T., Pastukhov D.V., Selivanova I.M., Shestakov A.L. Fundoplication in modification of the Russian Scientific Center of Surgery in the treatment of patients with gastroesophageal reflux disease. Clinical and experimental surgery. Petrovsky journal, 2014, № 3, pp. 28–33. (In Russ.)

14. FalcÃo A.M., Nasi A., Szachnowicz S., Santa-Cruz F., Seguro F.C.B.C., Sena B.F., Duarte A., Sallum R.A., Cecconello I. Does the Nissen fundoplication procedure improve esophageal dysmotility in patients with barrett’s esophagus? Rev Col Bras Cir. 2020, № 47, pp. 26–37. https://doi.org/10.1590/0100-6991e-20202637

15. Oleynikov D., Eubanks T.R., Oelschlager B.K., Pellegrini C.A. Total fundoplication is the operation of choice for patients with gastroesophageal reflux and defective peristalsis. Surg Endosc., 2002, № 16, pp. 909–913. https://doi.org/10.1007/s00464-001-8327-z

16. Diener U., Patti M.G., Molena D., Fisichella P.M., Way L.W. Esophageal dysmotility and gastroesophageal reflux disease. J Gastrointest Surg Off J Soc Surg Aliment Tract, 2001, № 5, pp. 260–265. https://doi.org/10.1016/s1091-255x(01)80046-9

17. Chernousov F.A., Shestakov A.L., Egorova L.K. Outcomes of fundoplications for the management of reflux esophagitis, Bulletin of Surgical Gastroenterology, 2009, № 4, pp. 64–69. (In Russ.)

18. Frankel A., Ong H.S., Smithers B.M., Nathanson L.K., Gotley D.C. Efficacy of laparoscopic fundoplication in patients with chronic cough and gastro-oesophageal reflux. Esophagus: official journal of the Japan Esophageal Society, 2023, №1, pp. 170–177. https://doi.org/10.1007/s10388-022-00953-2

19. Pizza F., Rossetti G., Limongelli P., et al. Influence of age on outcome of total laparoscopic fundoplication for gastroesophageal reflux disease. World J Gastroenterol., 2007, № 13 (5), pp. 740–747. https://doi.org/10.3748/wjg.v13.i5.740

20. Limpert P.A., Naunheim K.S. Partial versus complete fundoplication: is there a correct answer? Surg Clin North Am., 2005, № 85 (3), pp. 399–410. https://doi.org/10.1016/j.suc.2005.01.008

21. Gehwolf P., Agerer T., Stacul N., Kienzl-Wagner K., Schäfer A., Berchtold V., Cakar-Beck F., Elisabeth G., Wykypiel H. Lap. Nissen fundoplication leads to better respiratory symptom control than Toupet in the long term of 20 years. Langenbecks Arch Surg., 2023, № 408 (1), pр. 372. https://doi.org/10.1007/s00423-023-03108-8

22. Ospanov O.B., Volchkova I.S. To the justification of choice of technique laparoscopic fundoplication. Modern problems of science and education, 2012, № 2. (In Russ.

23. Peristeri D.V, Room H., Tsironis D., Vasilikostas G., Wan A. Longterm efficacy of total versus posterior partial fundoplication in patients with gastro-oesophageal reflux disease: a systematic review and meta-analysis, Ann R Coll Surg Engl., 2024, № 106(7), pp. 569–575. https://doi.org/10.1308/rcsann.2023.0046

24. Yadlapati R., Hungness E.S., Pandolfino J.E. Complications of Antireflux Surgery, The American journal of gastroenterology, 2018, № 113 (8), pp. 1137–1147. https://doi.org/10.1308/rcsann.2023.0046

25. Armijo P.R., Hennings D., Leon M., Pratap A., Wheeler A., Oleynikov D. Surgical management of gastroesophageal reflux disease in patients with severe esophageal dysmotility, J Gastrointest Surg., 2019, № 23 (1), pp. 36–42. https://doi.org/10.1007/s11605-018-3968-6

26. Watson D.I., Jamieson G.G., Bessell J.R., et al. Laparoscopic fundoplication in patients with an aperistaltic esophagus and gastroesophageal reflux. Diseases of the esophagus:official journal of the International Society for Diseases of the Esophagus, 2006, № 19(2), pp. 94–98. https://doi.org/10.1111/j.1442-2050.2006.00547.x

27. Zaninotto G., DeMeester T.R., Schwizer W., Johansson K.E., Cheng S.C. The lower esophageal sphincter in health and disease. American journal of surgery, 1988, № 155 (1), pp. 104–111. https://doi.org/10.1016/s0002-9610(88)80266-6

28. Chernousov F.A., Egorova L.K., Shestakov A.L., Godjello E.A., Lipko N.S. The long-term results of fundoplication in the reflux-esophagitis treatment in modification of A.F. Chernousov. Bulletin of Surgical Gastroenterology, 2010, № 4, pp. 29–39. (In Russ.)

29. Tam V., Winger D.G., Nason K.S. A systematic review and metaanalysis of mesh vs suture cruroplasty in laparoscopic large hiatal hernia repair. Am J Surg, 2016, № 211(1), pp. 226–238. https://doi.org/10.1016/j.amjsurg.2015.07.007