Department of Gastroesophageal Reflux Disease, PLA Rocket Force Characteristic Medical Center, Beijing, China.
Medicine (Baltimore). 2023 May 19;102(20):e33779. doi: 10.1097/MD.0000000000033779.
Gastroesophageal reflux-related chronic cough (GERC), is one common type of chronic cough. Drug treatment is effective for some GERC patients. But, there is refractory GERC (rGERC). For rGERC, fundoplication may be the only effective method. However, there were very few studies about laparoscopic fundoplication in treating rGERC, and the cure rate of fundoplication in treating rGERC was unknown. So there is a question, what is the cure rate of fundoplication in treating rGERC? To solve this question, we performed this meta-analysis.
The PRISMA strategy and Cochrane collaboration method were used for this study. Our study was registered with PROSPERO (ID: CRD42021251072). We searched PubMed, Medline, Web of Science, and the Cochrane databases from 1990 to December 2022. The meta-analysis was performed with Review Manager 5.4 and Stata 14.
After selection and exclusion, 8 articles out of 672 were included. The meta-analysis showed the cure rate of laparoscopic fundoplication in treating rGERC was 62% (95% confidence interval: 53-71%), with no deaths in 503 patients. There was no significant heterogeneity or bias in the meta-analysis.
In terms of safety, laparoscopic fundoplication is quite reliable offered by skilled surgeons. In terms of cure rate, laparoscopic fundoplication could completely heal two-thirds of rGERC patients; however, there are still some patients who can not be completely cured by fundoplication.
胃食管反流相关性慢性咳嗽（GERC）是一种常见的慢性咳嗽类型。药物治疗对一些 GERC 患者有效。但是，存在难治性 GERC（rGERC）。对于 rGERC，胃底折叠术可能是唯一有效的方法。然而，关于腹腔镜胃底折叠术治疗 rGERC 的研究很少，胃底折叠术治疗 rGERC 的治愈率也不清楚。因此，存在一个问题，即胃底折叠术治疗 rGERC 的治愈率是多少？为了解决这个问题，我们进行了这项荟萃分析。
本研究采用 PRISMA 策略和 Cochrane 协作方法。我们的研究已在 PROSPERO（ID：CRD42021251072）上注册。我们从 1990 年到 2022 年 12 月检索了 PubMed、Medline、Web of Science 和 Cochrane 数据库。使用 Review Manager 5.4 和 Stata 14 进行荟萃分析。
经过筛选和排除，从 672 篇文章中选出 8 篇纳入分析。荟萃分析显示，腹腔镜胃底折叠术治疗 rGERC 的治愈率为 62%（95%置信区间：53-71%），503 例患者中无死亡病例。荟萃分析中无明显异质性或偏倚。
就安全性而言，熟练外科医生实施的腹腔镜胃底折叠术非常可靠。就治愈率而言，腹腔镜胃底折叠术可以完全治愈三分之二的 rGERC 患者；然而，仍有一些患者不能通过胃底折叠术完全治愈。
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