“Laparoscopic paraesophageal hernia repair is a complex surgical problem with many variables that can affect the outcome. Based on the results of our carefully selected patients, the addition of a fundoplication minimizes postoperative reflux symptoms without additional operative time. In addition, neither dysphagia nor paraesophageal hernia recurrence is affected by the presence of a fundoplication.”
Torres-Villalobos G, et al. Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry. J Gastrointest Surg. 2018 Jan;22(1):13-22.
Full-text for Emory users.
Results: Seventy-three patients were randomized, 38 underwent Dor and 35 Toupet. Baseline characteristics were similar between groups. Postoperative HRM showed that the integrated relaxation pressure (IRP) and basal lower esophageal sphincter (LES) pressure were similar at 6 and 24 months. The number of patients with abnormal acid exposure was significantly lower for Dor (6.9%) than that of Toupet (34.0%) at 6 months, but it was not different at 12 or 24 months. No differences were found in postoperative symptom scores at 1, 6, or 24 months.
Conclusion: There were no differences in symptom scores or HRM between fundoplications in the long term. A higher percentage of abnormal 24-h pH test were found for the Toupet group, with no difference in the long term.
More PubMed results on Dor vs.Toupet fundoplication after Heller myotomy.
Surgical Focus 