Objective To investigate the clinical efficacy and postoperative outcomes of laparoscopic Toupet and Nissen fundoplication in treatment of refractory gastroesophageal reflux disease (rGERD). Methods The clinical data of 74 patients with rGERD who underwent laparoscopic Toupet (Toupet group

44 cases) and Nissen fundoplication (Nissen group

30 cases) in our department from December 2014 to January 2019 were retrospectively analyzed.Preoperative and postoperative esophageal highresolution manometry

24hour pH monitoring，as well as GERD-Q questionnaire of the two groups were evaluated.Results No incidence of death and severe complication happened，and the reflux symptom were significantly relieved in both of the two groups(P<0.05).The DeMeester score，lower esophageal sphincter pressure (LESP)，integrated relaxation pressure(IRP)

distal contractile integral(DCI)，reflux frequency and GERD-Q scores were significantly improved in both of the two groups (P<0.05).There was no significant difference in operative duration，intraoperative blood loss，postoperative hospital stay and fasting duration of the two groups (P>0.05).A higher frequency of dysphagia was present in the Nissen group(7 cases，23.3%) compared with the Toupet group (2 cases，4.5%)

and the difference between the two groups was statistically significant (P<0.05).Conclusion Both laparoscopic Toupet and Nissen fundoplication are safe and effective in treatment of rGERD，but laparoscopic Toupet has a lower incidence of postoperative dysphagia compared with Nissen fundoplication.