AIM: To compare the effect of antireflux surgery with medicine in treating gastroesophageal reflux disease(GERD) patients using meta- analysis.METHODS: MEDLINE, Embase and the Cochrane Library were searched. We only included randomized controlled trials(RCTs) comparing the effect of surgical intervention with medical therapy for GERD. Statistical analyses were performed using Rev Man 5.2 and STATA 12.0 software. Rev Man 5.2 was used to assess the risk of bias and calculate the pooled effect size, while Stata 12.0 was used to evaluate publication bias and for sensitivity analysis. We evaluated the primary outcomes with GERD-/health-related quality of life in short(one to three years) and long(three to twelve years) periods of follow-up. Secondary outcomes evaluated were De Meester scores and the percentage of time that p H < 4 to evaluate the degree of acid exposure.RESULTS: This meta-analysis included 7 studies with 1972 patients. It showed a positive effect of antireflux surgery compared with medical treatment in terms of health-related quality of life [standardized mean difference(SMD) = 0.18; 95%CI: 0.01 to 0.34] and GERD-related quality of life(SMD = 0.35; 95%CI: 0.11 to 0.59). We also conducted the subgroup analyses based on follow-up periods and found that surgery remained more effective than medicine over the short to medium follow-up time, but the advantage of antireflux surgery probably not maintained for long time. GERD-related quality of life in the surgical group was significantly higher than medical group for the < 3 years follow-up(SMD = 0.45; 95%CI: 0.23 to 0.66); the difference was not statistically significant when the follow-up time was ≥ 3 years(SMD = 0.30; 95%CI:-0.10 to 0.69). Meta-analysis showed a statistically significant difference between thesurgical group and medical group in the percentage of time that p H < 4(SMD = 0.38; 95%CI: 0.14 to 0.61). Meta-analysis indicated a positive effect of antireflux surgery compared with medical treatment concerning De Meester scores(SMD = 0.32; 95%CI: 0.00 to 0.65).CONCLUSION: Although both were effective, in some respects surgical intervention was more effective than medical therapy to treat GERD when follow-up time was up to three years.
展开▼
机译：Conhecimento sobre adoençaeexpectativas do tratamento em familiares de pacientes noprimeiroepisódiopsicótico：um estudo transversal Conocimiento sobre la enfermedad y expectativas acerca del tratamiento en los familiares de pacientes en el primerepisodiopicicótico：un estudio transversal the disease of the disease and treatment expectations在患有第一次精神病发作的患者的亲属中：横断面研究
机译：Therapeutic effect on disease and treatment of delta TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA ta TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA ta TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA TA ta TA TA TA ta_kappa_
