Table 2 .

Summary of change in reflux symptom index following fundoplication

Study	Type	Evidence level	n	Preoperative PPI	Fundoplication type	Mean follow-up duration in months (range)		RSI (mean ± SD)	RSI change	p-value
Carroll et al (2016)33	Retrospective case series	IV	9	3 months BD high-dose PPI	LNF	9.9 (4–24)		31.7 to 10.0	21.7	< 0.001
Catania et al (2007)29	Prospective, consecutive case series	IV	61	Not specified	LNF	15.2 (1–36)		31.5 ± 7.4 to 12.4 ± 10.9	19.1	< 0.01
Iqbal et al (2008)22	Retrospective case series	IV	40	Optimal medical therapy including PPIa	9 open 31 laparoscopic	41.5b (6–120)		22.8 ± 10.8 to 11.83 ± 9.91	10.97	< 0.0001
Ogut et al (2007)30	Prospective case series	IV	38	Not specified	LNF	14.0		25.45 ± 7.5 to 16.52 ± 5.06	8.93	< 0.05
Sahin et al (2015)27	Prospective, single-blind, case–control study (GORD vs LPR group 1)	III	41	Daily PPIa	LNF	24.5 ± 1.3 (LPR) 25.2 ± 1.1 (GORD)		22.86 ± 7.4 to 11.27 ± 6.6 (LPR) 12.91 ± 6.4 to 8.41 ± 4.5 (GORD)	11.59 4.5	0.00 (LPR) 0.001 (GORD)
Suzuki et al (2017)34	Retrospective case series	IV	12	11 patients on PPIa	LNF	6.0b (2–10)		22.9 ± 10.0 to 6.8 ± 6.8	16.1	< 0.001
Weitzendorfer et al (2017)31	Prospective, consecutive case series	IV	20	6-month preoperativea	LTF	3.0		21.9 ± 6.9 to 10.1 ± 6.6	11.8	< 0.001
Westcott et al (2004)32	Prospective case series	IV	41	Not specified	LNF	13.9 ± 4.1		RSI 23.2 + 12.0 to 16.7 + 11.5b	6.5b	< 0.05
Zhang et al (2017)28	Retrospective case–control study (LNF vs PPI)	III	31	Not specified	LNF	48 .0 (20.4–30)		LNF: 15.3 ± 3.5 to 9.7 ± 4.12 Control: 14.2 ± 4.0 to 12.8 ± 3.12	5.6	LNF Vs PPI (p = 0.004)

PPI = proton pump inhibitor; BD = twice daily; LNF = laparoscopic Nissen fundoplication; LTF = laparoscopic Toupet fundoplication; n = number of patients who underwent fundoplication; RSI = reflux symptom index; SD = standard deviation

^a PPI type and dose not specified

^b Median