PDF(Pubmed)
Abstract：
There are several options for the surgical management of GERD in adults. Previous guidelines and systematic reviews have compared the effects of total fundoplication versus pooled effects of different techniques of partial fundoplication.
To develop evidence-informed, trustworthy, pertinent recommendations on the use of total, posterior partial and anterior partial fundoplications for the management of GERD in adults.
We performed an update systematic review, network meta-analysis, and evidence appraisal using the GRADE and the Confidence in Network Meta-Analysis methodologies. An international, multidisciplinary panel of surgeons, gastroenterologists, and a patient representative reached unanimous consensus through an evidence-to-decision framework to select among multiple interventions, and a Delphi process to formulate the recommendation. The project was developed in an online authoring and publication platform (MAGICapp), and was overseen by an external auditor.
We suggest posterior partial fundoplication over total posterior or anterior 90° fundoplication in adult patients with GERD. We suggest anterior >90° fundoplication as an alternative, although relevant comparative evidence is limited (weak recommendation). The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/j20X4n.
This rapid guideline was developed in line with highest methodological standards and provides evidence-informed recommendations on the surgical management of GERD. It provides user-friendly decision aids to inform healthcare professionals\' and patients\' decision making.
To develop evidence-informed, trustworthy, pertinent recommendations on the use of total, posterior partial and anterior partial fundoplications for the management of GERD in adults.
We performed an update systematic review, network meta-analysis, and evidence appraisal using the GRADE and the Confidence in Network Meta-Analysis methodologies. An international, multidisciplinary panel of surgeons, gastroenterologists, and a patient representative reached unanimous consensus through an evidence-to-decision framework to select among multiple interventions, and a Delphi process to formulate the recommendation. The project was developed in an online authoring and publication platform (MAGICapp), and was overseen by an external auditor.
We suggest posterior partial fundoplication over total posterior or anterior 90° fundoplication in adult patients with GERD. We suggest anterior >90° fundoplication as an alternative, although relevant comparative evidence is limited (weak recommendation). The guideline, with recommendations, evidence summaries and decision aids in user friendly formats can also be accessed in MAGICapp: https://app.magicapp.org/#/guideline/j20X4n.
This rapid guideline was developed in line with highest methodological standards and provides evidence-informed recommendations on the surgical management of GERD. It provides user-friendly decision aids to inform healthcare professionals\' and patients\' decision making.
摘要：
背景：成人GERD的外科治疗有几种选择。以前的指南和系统综述比较了完全胃底折叠术的效果与不同部分胃底折叠术技术的综合效果。
目的：为了建立证据，值得信赖,关于使用总量的相关建议，成人GERD治疗的后部部分和前部部分胃底折叠。
方法：我们进行了最新的系统评价，网络荟萃分析，使用GRADE和网络元分析方法的信心进行证据评估。一个国际,多学科外科医生小组，胃肠病学家,患者代表通过证据决策框架达成一致共识，在多种干预措施中进行选择，和Delphi程序来制定建议。该项目是在在线创作和出版平台（MAGICapp）中开发的，并由外部审计师监督。
结果：我们建议成人GERD患者的后部部分胃底折叠术优于全部后部或前部90°胃底折叠术。我们建议前路>90°胃底折叠术作为替代方法，尽管相关比较证据有限(弱推荐).准则,有建议,用户友好格式的证据摘要和决策辅助工具也可以在MAGICapp中访问：https://app。magicapp.org/#/guideline/j20X4n。
结论：该快速指南是根据最高方法学标准制定的，并提供了关于GERD手术治疗的循证建议。它提供用户友好的决策辅助工具，以告知医疗保健专业人员和患者的决策。
目的：为了建立证据，值得信赖,关于使用总量的相关建议，成人GERD治疗的后部部分和前部部分胃底折叠。
方法：我们进行了最新的系统评价，网络荟萃分析，使用GRADE和网络元分析方法的信心进行证据评估。一个国际,多学科外科医生小组，胃肠病学家,患者代表通过证据决策框架达成一致共识，在多种干预措施中进行选择，和Delphi程序来制定建议。该项目是在在线创作和出版平台（MAGICapp）中开发的，并由外部审计师监督。
结果：我们建议成人GERD患者的后部部分胃底折叠术优于全部后部或前部90°胃底折叠术。我们建议前路>90°胃底折叠术作为替代方法，尽管相关比较证据有限(弱推荐).准则,有建议,用户友好格式的证据摘要和决策辅助工具也可以在MAGICapp中访问：https://app。magicapp.org/#/guideline/j20X4n。
结论：该快速指南是根据最高方法学标准制定的，并提供了关于GERD手术治疗的循证建议。它提供用户友好的决策辅助工具，以告知医疗保健专业人员和患者的决策。
