Efficacy of Laparoscopic Nissen Fundoplication vs Transoral Incisionless Fundoplication or Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease: Misleading Ranking Probabilities in Network Meta-analysis

We read the systematic review and network meta-analysis published in the Journal by Richter et al1 regarding the efficacy of laparoscopic Nissen fundoplication (LNF) versus transoral incisionless fundoplication (TIF) or proton pump inhibitors (PPIs) in patients with gastroesophageal reflux disease (GERD). We raise serious methodologic and clinical concerns about the validity of this study that seems to be heavily biased in favor of LNF with little substantiating evidence to support the conclusions the authors make.

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