Long-term efficacy of transoral incisionless and surgical laparoscopic fundoplication for treatment of gastro-esophageal reflux disease: a systematic-review and comparative meta-analysis

Aims Up to 40% of patients with gastro-esophageal reflux disease (GERD) do not respond to medical therapy. Laparoscopic fundoplication (LF) for GERD provides suboptimal outcomes and risk of long-lasting adverse events. Transoral incisionless fundoplication (TIF) may be proposed as alternative treatment for GERD. TIF and LF long-term effects have not been compared so far, to assess the real efficacy of TIF in clinical practice. We aimed at comparing the long-term outcomes of TIF and 360 LF or partial (anterior 90 to 180 or posterior 270) LF in GERD patients [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Methods A systematic search of major databases was performed up to September 2025. Studies reporting 5-to 10-year outcomes of TIF and LF in patients with confirmed GERD were included. Randomized controlled trials comparing 360 and partial LF were considered. Pooled proportions and 95 …