Cirugía de fundoplicatura laparoscópica versus tratamiento médico para la enfermedad por reflujo gastroesofágico (ERGE) en adultos
Appendices
Appendix 1. CENTRAL search strategy
Date Run: 16 June 2015. Via OVID platform
106 trials
CENTRAL (Cochrane Central Register of Controlled Trials) (The Cochrane Library Issue 8 of 12, August 2014)
ID Search
#1 MeSH descriptor: [Esophagus] explode all trees
#2 (esophag* or oesophag*)
#3 MeSH descriptor: [Gastroesophageal Reflux] explode all trees
#4 gastroesophageal reflux
#5 gastro oesophageal reflux
#6 gord
#7 gerd
#8 MeSH descriptor: [Duodenogastric Reflux] explode all trees
#9 bile reflux
#10 acid reflux
#11 gastric acid secret*
#12 stomach acid secret*
#13 gastric eros*
#14 stomach eros*
#15 MeSH descriptor: [Heartburn] this term only
#16 heartburn
#17 indigestion
#18 MeSH descriptor: [Esophagitis] explode all trees
#19 esophagitis
#20 oesophagitis
#21 low* sphincter* pressur*
#22 MeSH descriptor: [Gastric Emptying] explode all trees
#23 MeSH descriptor: [Gastroparesis] explode all trees
#24 MeSH descriptor: [Gastritis] explode all trees
#25 gastr* empt* disorder*
#26 stomach empt* disorder*
#27 MeSH descriptor: [Dyspepsia] this term only
#28 dyspep*
#29 MeSH descriptor: [Eructation] this term only
#30 eructation
#31 regurgitat*
#32 MeSH descriptor: [Hernia, Hiatal] this term only
#33 {OR #1 ‐ #32}
#34 MeSH descriptor: [Proton Pump Inhibitors] 1 tree(s) exploded
#35 proton pump inhibitor*
#36 ppi
#37 omeprazole
#38 esomeprazole
#39 lansoprazole
#40 pantoprazole
#41 rabeprazole
#42 MeSH descriptor: [Histamine H2 Antagonists] explode all trees
#43 cimetidine
#44 famotidine
#45 nizatidine
#46 ranitidine
#47 burimamide
#48 {OR #34 ‐ #47}
#49 MeSH descriptor: [Fundoplication] this term only
#50 fundoplication*
#51 nissen or rossetti
#52 toupet or lind or watson or besley
#53 {OR #49 ‐ #52}
#54 #33 and #48 and #53
Appendix 2. MEDLINE search strategy
Date of Search: Ovid MEDLINE 16 June 2015
Database: Ovid MEDLINE(R) <1946 to 16 June 2015>
1. exp Esophagus/
2. (esophag$ or oesophag$).mp.
3. exp gastroesophageal reflux/
4. (gastroesophageal adj3 reflux).mp.
5. (gastro adj3 oesophageal adj3 reflux).mp.
6. (gastro adj3 esophageal adj3 reflux).mp.
7. (gerd or gord).mp.
8. exp Duodenogastric Reflux/
9. bile reflux.mp.
10. (acid adj3 reflux).mp.
11. (gastric adj3 acid adj3 secret$).mp.
12. (stomach adj3 acid adj3 secret$).mp.
13. (gastric adj3 eros$).mp.
14. (stomach adj3 eros$).mp.
15. Heartburn/
16. (heartburn or indigestion).mp.
17. exp Esophagitis/
18. (esophagitis or oesophagitis).mp.
19. (low$ adj6 sphincter$ adj3 pressur$).mp.
20. Gastric Emptying/
21. Gastroparesis/
22. exp Gastritis/
23. (gastr$ adj3 empt$ adj3 disorder$).mp.
24. (stomach adj3 empt$ adj3 disorder$).mp.
25. Dyspepsia/
26. dyspep$.mp.
27. Eructation/
28. eructation.mp.
29. regurgitat$.mp.
30. Hernia, Hiatal/
31. hernia$ hiat$.mp.
32. or/1 ‐31
33. exp Proton Pump Inhibitors/
34. (proton adj3 pump adj3 inhibitor$).mp.
35. ppi.mp.
36. omeprazole.mp.
37. esomeprazole.mp.
38. lansoprazole.mp.
39. pantoprazole.mp.
40. rabeprazole.mp.
41. exp proton pumps/ai [Antagonists & Inhibitors]
42. exp Histamine H2 Antagonists/
43. (histamine H2 adj3 antagonist$).mp.
44. H2RA$.mp.
45. cimetidine.mp.
46. famotidine.mp.
47. nizatidine.mp.
48. ranitidine.mp.
49. burimamide.mp.
50. or/33 ‐ 49
51. Fundoplication/
52. fundoplication$.mp.
53. (nissen or rossetti).mp.
54. (toupet or lind or watson or besley).mp.
55. 51 or 52 or 53 or 54
56. 32 and 50 and 55
57. randomized controlled trial.pt.
58. controlled clinical trial.pt.
59. randomized.ab.
60. randomly.ab.
61. placebo.ab.
62. drug therapy.fs.
63. trial.ab.
64. groups.ab.
65. or/57 ‐ 64
66. 56 and 65
Lines 57‐64 were modified from Box 6.4.c: Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity‐maximizing version (2008 revision); Ovid format in Higgins 2011a.
Appendix 3. EMBASE search strategy
Date run in Embase (OVID): 16 June 2015
Database: Embase Classic+Embase 1947 to 16 June 2015
1. exp esophagus/
2. (esophag$ or oesophag$).mp.
3. exp gastroesophageal reflux/
4. (gastroesophageal adj3 reflux).mp.
5. (gastro adj3 oesophageal adj3 reflux).mp.
6. (gastro adj3 esophageal adj3 reflux).mp.
7. (gerd or gord).mp.
8. exp duodenogastric reflux/
9. bile reflux.mp.
10. (acid adj3 reflux).mp.
11. (gastric adj3 acid adj3 secret$).mp.
12. (stomach adj3 acid adj3 secret$).mp.
13. (gastric adj3 eros$).mp.
14. (stomach adj3 eros$).mp.
15. heartburn/
16. (heartburn or indigestion).mp.
17. exp esophagitis/
18. (esophagitis or oesophagitis).mp.
19. (low$ adj6 sphincter$ adj3 pressur$).mp.
20. stomach emptying/
21. stomach paresis/
22. exp gastritis/
23. (gastr$ adj3 empt$ adj3 disorder$).mp.
24. (stomach adj3 empt$ adj3 disorder$).mp.
25. dyspepsia/
26. dyspep$.mp.
27. eructation/
28. eructation.mp.
29. regurgitat$.mp.
30. hiatus hernia/
31. hernia$ hiat$.mp.
32. or/1‐ 31
33. proton pump inhibitor/
34. (proton adj3 pump adj3 inhibitor$).mp.
35. ppi.mp.
36. omeprazole/
37. omeprazole.mp.
38. esomeprazole/
39. esomeprazole.mp.
40. lansoprazole/
41. lansoprazole.mp.
42. pantoprazole/
43. pantoprazole.mp.
44. rabeprazole/
45. rabeprazole.mp.
46. histamine H2 receptor antagonist/
47. (histamine H2 adj3 antagonist$).mp.
48. H2RA$.mp.
49. cimetidine/
50. cimetidine.mp.
51. famotidine/
52. famotidine.mp.
53. nizatidine/
54. nizatidine.mp.
55. ranitidine/
56. ranitidine.mp.
57. burimamide/
58. burimamide.mp.
59. or/33 ‐ 58
60. stomach fundoplication/
61. fundoplication$.mp.
62. (nissen or rossetti).mp.
63. (toupet or lind or watson or besley).mp.
64. 60 or 61 or 62 or 63
65. 32 and 59 and 64
66. crossover procedure/
67. double blind procedure/
68. randomized controlled trial/
69. single‐blind procedure/
70. random$.ab.
71. factorial$.ab.
72. crossover$.ab.
73. cross over$.ab.
74. cross‐over$.ab.
75. placebo$.ab.
76. (doubl$ adj blind$).ab.
77. (singl$ adj blind$).ab.
78. assign$.mp.
79. allocat$.ab.
80. volunteer$.ab.
81. or/66 ‐ 80
82. 65 and 81
Results: 199
Lines 66‐80 from sections 6.4.11.2 Search filters for identifying randomized trials in EMBASE and section 6.3.2.2 What is in The Cochrane Central Register of Controlled Trials (CENTRAL) from EMBASE? in Higgins 2011a.
Appendix 4. Previous search strategies
CENTRAL search strategy
#1 esophagus/
#2 (esophag* or oesophag*)
#3 exp gastroesophageal reflux/
#4 (gastroesophageal reflux)
#5 gastro oesophageal reflux
#6 gord
#7 gerd
#8 duodenogastric reflux/
#9 bile reflux/
#10 acid reflux
#11 gastric acid secret*
#12 stomach acid secret*
#13 gastric eros*
#14 (stomach eros*)
#15 heartburn/
#16 (heartburn or indigestion)
#17 esophagitis/
#18 esophagitis
#19 oesophagitis
#20 (low* sphincter* pressur*)
#21 les
#22 gastric emptying/
#23 gastroparesis/
#24 gastritis/
#25 gastr* empt* disorder*
#26 stomach empt* disorder
#27 dyspepsia/
#28 dyspep*
#29 eructation/
#30 eructat*
#31 regurgitat*
#32 Hiatal hernia
#33 (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR ( # AND 20 ) OR #21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32)
#34 proton pump/
#35 proton pump inhibitor*
#36 ppi
#37 Omeprazole/
#38 omeprazole
#39 esomeprazole
#40 lansoprazole
#41 pantoprazole
#42 rabeprazole
#43 Histamine H2 Antagonists/
#44 cimetidine
#45 Cimetidine/
#46 Famotidine
#47 Nizatidine
#48 Ranitidine
#49 (#34 OR #35 OR #36 OR #37 OR #38 OR #39 OR #40 OR #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48)
#50 Fundoplication/
#51 nissen or rossetti
#52 toupet or lind or watson or besley
#53 (partial* fundoplication*)
#54 (laparoscop* fundoplication*)
#55 (#50 OR #51 OR #52 OR #53 OR #54)
#56 (#33 AND #49 AND #55), from 2006 to 2009
EMBASE search strategy
-
(random$ or placebo$).ti,ab.
-
((single$ or double$ or triple$ or treble$) and (blind$ or mask$)).ti,ab.
-
controlled clinical trial$.ti,ab.
-
RETRACTED ARTICLE/
-
or/1‐4
-
(animal$ not human$).sh,hw.
-
5 not 6
-
exp esophagus/
-
(esophag$ or oesophag$).tw.
-
exp gastroesophageal reflux/
-
(gastroesophageal adj3 reflux).tw.
-
(gastro adj3 oesophageal adj3 reflux).tw.
-
(gastro adj3 esophageal adj3 reflux).tw.
-
gord.tw.
-
gerd.tw.
-
exp duodenogastric reflux/
-
exp bile reflux/
-
(acid adj3 reflux).tw.
-
(gastric adj3 acid adj3 secret$).tw.
-
(stomach adj3 acid secret$).tw.
-
(gastric adj3 eros$).tw.
-
(stomach adj3 eros$).tw.
-
exp heartburn/
-
(heartburn or indigestion).tw.
-
exp esophagitis/
-
esophagitis.tw.
-
oesophagitis.tw.
-
(low$ adj6 sphincter$ adj3 pressur$).tw.
-
les.tw.
-
exp gastric emptying/
-
exp gastroparesis/
-
exp gastritis/
-
(gastr$ adj3 empt$ adj3 disorder$).tw.
-
(stomach adj3 empt$ adj3 disorder).tw.
-
exp dyspepsia/
-
dyspep$.tw.
-
exp eructation/
-
eructat$.tw.
-
regurgitat$.tw.
-
Hernia, Hiatal/
-
or/8‐40
-
exp proton pump/
-
esomeprazole.mp.
-
(proton adj3 pump adj3 inhibitor$).tw.
-
ppi.tw.
-
exp Omeprazole/
-
omeprazole.tw.
-
lansoprazole.tw.
-
pantoprazole.tw.
-
rabeprazole.tw.
-
exp Histamine H2 Antagonists/
-
cimetidine.tw.
-
exp Cimetidine/
-
famotidine.tw. or exp Famotidine/
-
nizatidine.tw. or exp Nizatidine/
-
ranitidine.tw. or exp Ranitidine/
-
or/42‐56
-
exp Fundoplication/
-
(nissen or rossetti).tw.
-
(toupet or lind or watson or besley).tw.
-
(partial$ adj5 fundoplication$).tw.
-
(laparoscop$ adj5 fundoplication$).tw.
-
or/58‐62
-
41 and 57 and 63
-
7 and 64
-
limit 65 to yr="2006 ‐Current"
MEDLINE search strategy
-
randomized controlled trial.pt.
-
controlled clinical trial.pt.
-
randomized.ab.
-
placebo.ab.
-
clinical trials as topic.sh.
-
randomly.ab.
-
trial.ti.
-
or/1‐7
-
(animals not (humans and animals)).sh.
-
8 not 9
-
exp esophagus/
-
(esophag$ or oesophag$).tw.
-
exp gastroesophageal reflux/
-
(gastroesophageal adj3 reflux).tw.
-
(gastro adj3 oesophageal adj3 reflux).tw.
-
(gastro adj3 esophageal adj3 reflux).tw.
-
gord.tw.
-
gerd.tw.
-
exp duodenogastric reflux/
-
exp bile reflux/
-
(acid adj3 reflux).tw.
-
(gastric adj3 acid adj3 secret$).tw.
-
(stomach adj3 acid secret$).tw.
-
(gastric adj3 eros$).tw.
-
(stomach adj3 eros$).tw.
-
exp heartburn/
-
(heartburn or indigestion).tw.
-
exp esophagitis/
-
esophagitis.tw.
-
oesophagitis.tw.
-
(low$ adj6 sphincter$ adj3 pressur$).tw.
-
les.tw.
-
exp gastric emptying/
-
exp gastroparesis/
-
exp gastritis/
-
(gastr$ adj3 empt$ adj3 disorder$).tw.
-
(stomach adj3 empt$ adj3 disorder).tw.
-
exp dyspepsia/
-
dyspep$.tw.
-
exp eructation/
-
eructat$.tw.
-
regurgitat$.tw.
-
Hernia, Hiatal/
-
or/11‐43
-
exp proton pump/
-
esomeprazole.mp.
-
(proton adj3 pump adj3 inhibitor$).tw.
-
ppi.tw.
-
exp Omeprazole/
-
omeprazole.tw.
-
lansoprazole.tw.
-
pantoprazole.tw.
-
rabeprazole.tw.
-
exp Histamine H2 Antagonists/
-
cimetidine.tw.
-
exp Cimetidine/
-
famotidine.tw. or exp Famotidine/
-
nizatidine.tw. or exp Nizatidine/
-
ranitidine.tw. or exp Ranitidine/
-
or/45‐59
-
exp Fundoplication/
-
(nissen or rossetti).tw.
-
(toupet or lind or watson or besley).tw.
-
(partial$ adj5 fundoplication$).tw.
-
(laparoscop$ adj5 fundoplication$).tw.
-
or/61‐65
-
44 and 60 and 66
-
10 and 67
-
limit 68 to yr="2006 ‐Current"
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 1 Health‐related quality of life (< 1 year).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 2 Health‐related quality of life (1 to 5 years).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 3 GORD‐specific quality of life (< 1 year).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 4 GORD‐specific quality of life (1 to 5 years).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 5 Serious adverse events.
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 6 Adverse events.
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 7 Dysphagia (< 1 year).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 8 Dysphagia (1 to 5 years).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 9 Dysphagia (5 years or more).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 10 Heartburn (< 1 year).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 11 Heartburn (1 to 5 years).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 12 Heartburn (5 years or more).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 13 Reflux (< 1 year).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 14 Reflux (1 to 5 years).
Comparison 1 Laparoscopic fundoplication versus medical management, Outcome 15 Reflux (5 years or more).
| Laparoscopic fundoplication versus medical management for gastro‐oesophageal reflux disease (GORD) in adults | ||||||
| Patient or population: Patients with gastro‐oesophageal reflux disease (GORD) in adults Control: Medical management | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Medical management | Laparoscopic fundoplication | |||||
| Health‐related quality of life | ||||||
| (< 1 year) | The mean health‐related quality of life (< 1 year) in the intervention groups was | 605 | ⊕⊝⊝⊝ | SMD 0.14 (‐0.02 to 0.3) | ||
| (1 to 5 years) | The mean health‐related quality of life (1 to 5 years) in the intervention groups was | 323 | ⊕⊝⊝⊝ | SMD 0.03 (‐0.19 to 0.24) | ||
| GORD‐specific quality of life | ||||||
| (< 1 year) | The mean GORD‐specific quality of life (< 1 year) in the intervention groups was | 1160 | ⊕⊕⊝⊝ | SMD 0.58 (0.46 to 0.7) | ||
| (1 to 5 years) | The mean GORD‐specific quality of life (1 to 5 years) in the intervention groups was | 994 | ⊕⊝⊝⊝ | SMD 0.28 (‐0.27 to 0.84) | ||
| Adverse events | ||||||
| Serious adverse events | 124 per 1000 | 181 per 1000 | RR 1.46 | 637 | ⊕⊝⊝⊝ | |
| Adverse events | 10 per 1000 | 140 per 1000 | RR 13.98 | 83 | ⊕⊝⊝⊝ | |
| Dysphagia | ||||||
| (< 1 year) | 36 per 1000 | 129 per 1000 | RR 3.58 | 637 | ⊕⊝⊝⊝ | |
| (1 to 5 years) | 19 per 1000 | 101 per 1000 | RR 5.36 | 554 | ⊕⊝⊝⊝ | |
| (5 years or more) | 255 per 1000 | 229 per 1000 | RR 0.9 | 228 | ⊕⊝⊝⊝ | |
| Heartburn | ||||||
| (< 1 year) | 222 per 1000 | 100 per 1000 | RR 0.45 | 554 | ⊕⊝⊝⊝ | |
| (1 to 5 years) | 222 per 1000 | 42 per 1000 | RR 0.19 | 554 | ⊕⊝⊝⊝ | |
| (5 years or more) | 736 per 1000 | 412 per 1000 | RR 0.56 | 217 | ⊕⊝⊝⊝ | |
| Reflux | ||||||
| (< 1 year) | 199 per 1000 | 20 per 1000 | RR 0.1 | 554 | ⊕⊝⊝⊝ | |
| (1 to 5 years) | 139 per 1000 | 21 per 1000 | RR 0.15 | 554 | ⊕⊝⊝⊝ | |
| (5 years or more) | 357 per 1000 | 246 per 1000 | RR 0.69 | 233 | ⊕⊝⊝⊝ | |
| Long‐term overall health‐related quality of life and long‐term GORD‐specific quality of life were not reported in any of the trials. | ||||||
| *The basis for the assumed risk was the mean control group risk across studies for all outcomes other than adverse events. For control group risk, 1% was used as the control group risk since there were no adverse events in the control group in the only trial that reported this outcome (Anvari 2011). The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 The trial(s) was/were at high risk of bias. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Health‐related quality of life (< 1 year) Show forest plot | 3 | 605 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.14 [‐0.02, 0.30] |
| 2 Health‐related quality of life (1 to 5 years) Show forest plot | 2 | 323 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.03 [‐0.19, 0.24] |
| 3 GORD‐specific quality of life (< 1 year) Show forest plot | 4 | 1160 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.58 [0.46, 0.70] |
| 4 GORD‐specific quality of life (1 to 5 years) Show forest plot | 3 | 994 | Std. Mean Difference (IV, Random, 95% CI) | 0.28 [‐0.27, 0.84] |
| 5 Serious adverse events Show forest plot | 2 | 637 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.46 [1.01, 2.11] |
| 6 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 7 Dysphagia (< 1 year) Show forest plot | 2 | 637 | Risk Ratio (M‐H, Fixed, 95% CI) | 3.58 [1.91, 6.71] |
| 8 Dysphagia (1 to 5 years) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 9 Dysphagia (5 years or more) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 10 Heartburn (< 1 year) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 11 Heartburn (1 to 5 years) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 12 Heartburn (5 years or more) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 13 Reflux (< 1 year) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 14 Reflux (1 to 5 years) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 15 Reflux (5 years or more) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
