***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: HYPOTHESIS Laparoscopic anterior 90 degrees partial fundoplication for gastroesophageal reflux is associated with a lower incidence of postoperative dysphagia and other adverse effects compared with laparoscopic Nissen fundoplication . DESIGN A multicenter , prospect i ve , double-blind , r and omized controlled trial . SETTING Nine university teaching hospitals in 6 major cities in Australia and New Zeal and . PARTICIPANTS One hundred twelve patients with proven gastroesophageal reflux disease presenting for laparoscopic fundoplication were r and omized to undergo either a Nissen ( 52 patients ) or an anterior 90 degrees partial procedure ( 60 patients ) . Patients with esophageal motility disorders , patients requiring a concurrent abdominal procedure , and patients who had undergone previous antireflux surgery were excluded from this study . INTERVENTIONS Laparoscopic Nissen fundoplication with division of the short gastric vessels or laparoscopic anterior 90 degrees partial fundoplication . MAIN OUTCOME MEASURES Independent assessment of dysphagia , heartburn , and overall satisfaction 1 , 3 , and 6 months after surgery using multiple clinical grading systems . Objective measurement of esophageal manometric parameters , esophageal acid exposure , and endoscopic assessment . RESULTS Postoperative dysphagia , and wind-related adverse effects were less common after a laparoscopic anterior 90 degrees partial fundoplication . Relief of heartburn was better following laparoscopic Nissen fundoplication . Overall satisfaction was better after anterior 90 degrees partial fundoplication . Lower esophageal sphincter pressure , acid exposure , and endoscopy findings were similar for both procedures . CONCLUSIONS At the 6-month follow-up , laparoscopic anterior 90 degrees culine partial fundoplication is followed by fewer adverse effects than laparoscopic Nissen fundoplication with full fundal mobilization , and it achieves a higher rate of satisfaction with the overall outcome . However , this is offset to some extent by a greater likelihood of recurrent gastroesophageal reflux symptoms Objective To determine the influence of preoperative esophageal motility on clinical and objective outcome of the Toupet or Nissen fundoplication and to evaluate the success rate of these procedures . Summary background data Nissen fundoplication ( 360 ° ) is the st and ard operation in the surgical management of gastroesophageal reflux disease ( GERD ) . In order to avoid postoperative dysphagia it has been proposed to tailor antireflux surgery according to pre-existing esophageal motility . Postoperative dysphagia is thought to occur more commonly in patients with esophageal dysmotility and it has been recommended to use the Toupet procedure ( 270 ° ) in these patients . We performed a r and omized trial to evaluate this tailored concept and to compare the two operative techniques concerning reflux control and complication rate ( dysphagia ) . Methods 200 patients with GERD were included in a prospect i ve , r and omized study . After preoperative examinations ( clinical interview , endoscopy , 24-hour pH-metry and esophageal manometry ) 100 patients underwent either a laparoscopic Nissen procedure  ( 50 with and 50 without motility disorders ) , or Toupet ( 50 with and 50 without motility disorders ) . Postoperative follow-up after two years included clinical interview , endoscopy , 24-hour pH-metry , and esophageal manometry . Results After two years 85 % ( Nissen ) and 85 % ( Toupet ) of patients were satisfied with the operative result . Dysphagia was more frequent following a Nissen fundoplication compared to Toupet ( 19 vs. 8 , p < 0.05 ) and did not correlate with preoperative motility . Concerning reflux control the Toupet proved to be as good as the Nissen procedure . Conclusion Tailoring antireflux surgery according to the esophageal motility is not indicated , as motility disorders are not correlated with postoperative dysphagia . The Toupet procedure is the better operation as it has a lower rate of dysphagia and is as good as the Nissen fundoplication in controlling reflux Background : With the introduction of laparoscopic antireflux surgery ( LARS ) for gastro-oesophageal reflux disease ( GORD ) along with the increasing efficacy of modern medical treatment , a direct comparison is warranted . The 3-year interim results of a r and omised study comparing both the efficacy and safety of LARS and esomeprazole ( ESO ) are reported . Methods : LOTUS is an open , parallel-group multicentre , r and omised and controlled trial conducted in dedicated centres in 11 European countries .  LARS was completed according to a st and ardised protocol , comprising a total fundoplication and a crural repair . Medical treatment comprised ESO 20 mg once daily , which could be increased stepwise to 40 mg once daily and then 20 mg twice daily in the case of incomplete GORD control . The primary outcome variable was time to treatment failure ( Kaplan – Meier analysis ) . Treatment failure was defined on the basis of symptomatic relapse requiring treatment beyond that stated in the protocol . Results : 554 patients were r and omised , of whom 288 were allocated to LARS and 266 to ESO .  The two study arms were well matched . The proportions of patients who remained in remission after 3 years were similar for the two therapies : 90 % of surgical patients compared with 93 % medically treated for the intention to treat population , p = 0.25 ( 90 % vs 95 % per protocol ) . No major unexpected postoperative complications were experienced and ESO was well tolerated . However , postfundoplication complaints remain a problem after LARS . Conclusions : Over the first 3 years of this long-term study , both laparoscopic total fundoplication and continuous ESO treatment were similarly effective and well-tolerated therapeutic strategies for providing effective control of GORD INTRODUCTION To evaluate the clinical outcomes of  laparoscopic floppy Nissen fundoplication ( LNF ) and laparoscopic Toupet fundoplication ( LTF ) for the treatment of gastroesophageal disease ( GERD ) . METHODS A total of 84 patients with GERD were r and omized to either LNF ( n = 43 ) or LTF ( n = 41 ) between January 2010 and January 2013 . The primary endpoint measures were the DeMeester score , distal esophageal amplitude ( DEA ) , peristaltic frequency , lower esophageal sphincter pressure ( LESP ) , short-term and long-term postoperative dysphagia and recurrence rate . The secondary endpoints were improvements in symptom scores and quality of life ( QoL ) , and perioperative complications . RESULTS LNF group had a lower DeMeester score and a higher LESP compared to LTF group after surgery ( DeMeester score : P = 0.007 ; LESP : P = 0.027 ) . The mean DEA and peristaltic frequency both improved significantly after surgery in 2 groups . There was no difference in the incidence of short-term adverse events ( including dysphagia , heartburn , regurgitation et al. ) between the two groups ( P = 0.157 ) . At the time of the latest follow-up , there was no difference in the incidence of symptomatic reflux symptom ( heartburn and regurgitation ) between the two groups ( heartburn : P = 0.363 ; regurgitation : P = 1.000 ) . A higher frequency of dysphagia was present in the LNF group compared with the LTF group ( P = 0.023 ) . DISCUSSION LNF is associated with an excessive elevation of LESP which may lead to further persistent dysphagia . Partial fundoplication may provide adequate reﬂux control , improve esophageal body motility and minimize complications associated with an ' over-tight ' fundal wrap . CONCLUSION LTF seems to be as safe and effective on the long-term as LNF , but with a lower incidence of postoperative dysphagia ( ChiCTR-TRC-13003945 ) BACKGROUND Very few r and omized controlled trials ( RCTs ) have compared laparoscopic Nissen fundoplication ( LNF ) to proton pump inhibitors ( PPI ) medical management for patients with chronic gastroesophageal reflux disease ( GERD ) . Larger RCTs have been relatively short in duration , and have reported mixed results regarding symptom control and effect on quality of life ( QOL ) . Economic evaluations have reported conflicting results . OBJECTIVES To determine the incremental cost-utility of LNF versus PPI for treating patients with chronic and controlled GERD over 3 years from the societal perspective . METHODS Economic evaluation was conducted alongside a RCT that enrolled 104 patients from October 2000 to September 2004 . Primary study outcome was GERD symptoms ( secondary outcomes included QOL and cost-utility ) . Re source utilization and QOL data collected at regular follow-up intervals determined incremental cost/QALY gained . Stochastic uncertainty was assessed using bootstrapping and method ologic assumptions were assessed using sensitivity analysis . RESULTS No statistically significant differences in GERD symptom scores , but LNF did result in fewer heartburn days and improved QOL . Costs were higher for LNF patients by $ 3205/patient over 3 years but QOL was also higher as measured by either QOL instrument . Based on total costs , incremental cost-utility of LNF was $ 29,404/QALY gained using the Health Utility Index 3 . Cost-utility results were sensitive to the utility instrument used ( $ 29,404/QALY for Health Utility Index 3 , $ 31,117/QALY for the Short Form 6D , and $ 76,310/QALY for EuroQol 5D ) and if current lower prices for PPIs were used in the analysis . CONCLUSIONS Results varied depending on re source use/costs included in the analysis , the QOL instrument used , and the cost of PPIs ; however , LNF was generally found to be a cost-effective treatment for patients with symptomatic controlled GERD requiring long-term management The aim of the present study was to evaluate the clinical effect of partial and total fundoplication on extraesophageal symptoms in a selected cohort of patients with gastroesophageal reflux disease ( GERD ) . Hundred patients with documented GERD were r and omized to either undergo floppy Nissen ( n=50 ) or Toupet fundoplication ( n=50 ) . Symptom scores of cough , asthma , hoarseness , and distortion of taste were prospect ively evaluated using a st and ardized symptom question naire before surgery and at 3- and 12-month follow-up . Statistical significance was set at a P-value of 0.05 . All evaluated symptoms exhibited substantial improvement after Nissen fundoplication at 3- and 12-month follow-up . Similar therapeutic results were documented for Toupet fundoplication , although statistical significance could not be reached for asthma at long-term follow-up . In conclusion , the application of laparoscopic fundoplication is justified for patients with documented GERD and atypical symptoms refractory to medical treatment . Toupet fundoplication may have a lesser effect on asthma Anterior partial fundoplication ( AF ) has been popularized by a lower risk of mechanical side effects . The question then emerges whether anterior partial wrap has a similar antireflux effect with Nissen fundoplication ( NF ) . We therefore conducted a r and omized study to compare the long-term outcome of anterior fundoplication with NF .  One hundred patients who enrolled in the trial from May 2003 to March 2005 were r and omized to laparoscopic AF or laparoscopic NF .  Endoscopy , pH monitoring , manometry , a detailed question naire , and a visual analog symptom score were completed preoperative at 6 , 12 , 24 , and 60 months after surgical procedures . The postoperative adverse effects such as dysphagia and flatulence were compared between the two groups . Revision surgery or maintenance proton pump inhibitor therapy was defined as failure . Fifty procedures were performed in each group . The outcome at 5 years follow-up was determined for 96 patients ( 96 % ; 49 patients in the AF group and 47 in the NF group ) . Three patients ( 3 % ) died of unrelated causes during follow-up , and one patient changed address . Both fundoplications were found to provide good control of reflux-related symptoms in most of the patients . For 96 patients followed up more than 5 years , gastroesophageal reflux symptoms were well controlled in 81 patients ( 84.38 % ) ; the mean DeMeester scores in the AF group decreased from 106.89 ± 14.12 to 12.67 ± 3.14 and in the NF group from 109.51 ± 17.98 to 10.81 ± 2.65 , and the esophagitis was ameliorated visibly . Moreover , there were significantly fewer patients in the AF group who complained of flatulence . Compared with NF , anterior 180 ° partial fundoplication is an effective treatment of gastroesophageal reflux and associates with fewer postoperative adverse effects Background The fundoplication of choice for the surgical treatment of gastroesophageal reflux disease ( GERD ) still is debated . Multichannel intraluminal impedance monitoring ( MII ) has not been used to compare objective data , and comparative subjective data on laparoscopic Nissen and Toupet fundoplications are scarce . Methods This study r and omly allocated 125 patients with 
    Output:
    
Regurgitation , morbidity , and reoperation were similar across treatments , albeit these were associated with very low- quality evidence .
Laparoscopic 270 ° fundoplication achieves a better outcome than 360 ° total fundoplication , especially in terms of postoperative dysphagia , although other types of partial fundoplication might be equally effective .