Abstract

Background: Gastroesophageal reflux disease (GERD) is a highly prevalent condition that impacts patients’ quality of life. When medical therapy fails, surgical treatment, particularly Nissen (NF) and Toupet fundoplication (TF), is indicated. Aims: To compare the efficacy, complications, and outcomes of NF and TF in GERD treatment. Methods: A systematic review was conducted in PubMed, Cochrane, SciELO, and LILACS (2002–2025). Randomized controlled trials and cohort studies comparing NF and TF with ≥12 months follow-up were included. Primary outcomes: postoperative dysphagia, reflux control. Secondary outcomes: PPI use, quality of life (QoL), reoperations. Results: Nine studies (2,130 patients) were included. Both techniques showed similar efficacy in reflux control. NF resulted in higher lower esophageal sphincter pressure but increased early postoperative dysphagia. TF preserved esophageal motility better and had lower early dysphagia rates. Long-term PPI use, QoL, and patient satisfaction were comparable. Conclusions: NF and TF are effective for GERD. NF increases sphincter pressure but with more dysphagia; TF offers better motility preservation and fewer side effects. Surgical choice should be individualized based on esophageal motility and patient characteristics.

Keywords

gastroesophageal reflux disease; nissen fundoplication; toupet fundoplication