A systematic review and meta-analysis compared total (Nissen) versus partial (Toupet) fundoplication in children under 18 with gastroesophageal reflux disease. The analysis included 2,633 patients from multiple studies.
Children who had total fundoplication were about 1.7 times more likely to have trouble swallowing after surgery compared to those who had partial fundoplication. This means about 6 more children out of 100 would have dysphagia with total fundoplication. For every 17 children treated with total instead of partial fundoplication, one extra case of dysphagia occurs.
Reflux recurrence rates were similar between the two procedures (about 7% with total vs. 14% with partial), but this difference was not statistically significant. Other outcomes like complications during surgery, general postoperative problems, need for repeat surgery, and death were also comparable.
The findings suggest that partial fundoplication may be a better option for many children because it lowers the risk of swallowing difficulties while still controlling reflux effectively. However, the results should be interpreted with caution due to some variability among the included studies.