Laparoscopic Reintervention for Failed Antireflux Surgery

Khajanchee, Yashodhan S.

doi:10.1001/archsurg.142.8.785

Cited by 80 publications

(23 citation statements)

References 30 publications

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“…In 1,435 reoperations (31.3%), the indication for reoperation was not reported. Preoperative symptoms were assessed by questionnaire in 26 studies (32.1%) 10,14,17,18,23–25,28,30,33,36,45,53,54,56,61–66,71,74,76,87,88. In most studies (93.8%), preoperative workup consisted of esophagogastroduodenoscopy, barium swallow, and/or esophageal pH monitoring 10–28,30–41,43–46,48–76,78,79,81–89…”

Section: Resultsmentioning

confidence: 99%

“…The reasons to perform esophageal resection were severe esophagitis with or without Barrett metaplasia,15,25,59 peptic stricture of the esophagus,10,33,51,57,72,81 severely disturbed esophageal motility,26,44,57,81 or short esophagus 70,82. In 202 reoperations (4.4%), gastric resection was performed.…”

Section: Resultsmentioning

confidence: 99%

“…In 202 reoperations (4.4%), gastric resection was performed. Indications for this were alkaline reflux,10 dense adhesions on attempted refundoplication,33,59,86 or severe gastric paresis 25,81…”

Section: Resultsmentioning

confidence: 99%

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Surgical Reintervention After Failed Antireflux Surgery: A Systematic Review of the Literature

Furnée

Draaisma

Broeders

et al. 2009

Journal of Gastrointestinal Surgery

188

106

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BackgroundOutcome and morbidity of redo antireflux surgery are suggested to be less satisfactory than those of primary surgery. Studies reporting on redo surgery, however, are usually much smaller than those of primary surgery. The aim of this study was to summarize the currently available literature on redo antireflux surgery.Material and MethodsA structured literature search was performed in the electronic databases of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials.ResultsA total of 81 studies met the inclusion criteria. The study design was prospective in 29, retrospective in 15, and not reported in 37 studies. In these studies, 4,584 reoperations in 4,509 patients are reported. Recurrent reflux and dysphagia were the most frequent indications; intraoperative complications occurred in 21.4% and postoperative complications in 15.6%, with an overall mortality rate of 0.9%. The conversion rate in laparoscopic surgery was 8.7%. Mean(±SEM) duration of surgery was 177.4 ± 10.3 min and mean hospital stay was 5.5 ± 0.5 days. Symptomatic outcome was successful in 81.1% and was equal in the laparoscopic and conventional approach. Objective outcome was obtained in 24 studies (29.6%) and success was reported in 78.3%, with a slightly higher success rate in case of laparoscopy than with open surgery (85.8% vs. 78.0%).ConclusionThis systematic review on redo antireflux surgery has confirmed that morbidity and mortality after redo surgery is higher than after primary surgery and symptomatic and objective outcome are less satisfactory. Data on objective results were scarce and consistency with regard to reporting outcome is necessary.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Reintervention After Failed Antireflux Surgery: A Systematic Review of the Literature

Furnée

Draaisma

Broeders

et al. 2009

Journal of Gastrointestinal Surgery

188

106

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“…After laparoscopic fundoplication, anatomic alterations of the EGJ are observed in 2% in non-Barrett's esophagus patients versus 16% in patients with Barrett's esophagus. [19][20][21][22][23][24][25][26][27][28] Martínez de Haro et al, 29 in 51 patients with reflux esophagitis followed for more than 6 years, obtained good results in 89% of patients, but endoscopic recurrence was higher (14%) and pathologic acid reflux confirmed by 24-hour pH monitoring was 20% after surgery. In Barrett's esophagus patients, the results are even worse.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19][20][21][22] However, there are several citations in the literature reporting failure rates of laparoscopic fundoplication from 2% to 17%. [22][23][24][25][26][27][28] These lower published rates probably reflect shorter follow-up rather than an intrinsically better operation. Besides, the majority of these reports do not include objective evaluation of the success or failure of antireflux surgery, such as endoscopic appearance, manometric measurements, or 24-hour pH studies.…”

mentioning

confidence: 98%

Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome

Braghetto

Korn

Csendes

et al. 2012

International Surgery

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After antireflux surgery for gastroesophageal reflux disease, 10% to 15% of patients may have unsuccessful results as a result of abnormal restoration of the esophagogastric junction. The purpose of this study was to evaluate the postoperative endoscopic and radiologic characteristics of the antireflux barrier and their correlation with the postoperative results. After surgery, endoscopic and radiologic features of the antireflux wrap were evaluated in 120 consecutive patients. Jobe's classification of the postoperative valve was used for the definition of a ''normal'' or ''defective'' wrap. Patients were evaluated 3 to 5 years later in order to determine the clinical and objective failed fundoplication. A ''normal'' antireflux wrap was associated with successful results in 81.7% of the patients. On the contrary, defective radiologic or endoscopic antireflux wrap was observed in 19% of cases. Among these patients, hypotensive lower esophageal sphincter was observed in 50% to 65% of patients, abnormal 24-hour pH monitoring in 91%, and recurrent postoperative erosive esophagitis in 50% of patients, respectively (P , 0.001). ''Defective'' antireflux fundoplication is associated with recurrent reflux symptoms, presence of endoscopic esophagitis, hypotensive lower esophageal sphincter, and abnormal acid reflux.Key words: Antireflux surgery -Postoperative failures -Defective fundoplication P atients with gastroesophageal reflux disease (GERD) have anatomic defects of the esophagogastric junction (EGJ) as dilatation of the cardia and/or presence of hiatal hernia. [1][2][3][4] These defects have been associated with incompetence of the lower esophageal sphincter (LES) and pathologic acid reflux. The aim of antireflux surgery is to create an antireflux barrier by increasing the competence of the LES and to avoid this abnormal acid reflux. However, failure of antireflux surgery has been reported in several publications and pathologic acid reflux test can be observed in 5% to 15% of GERD patients. 5,6 Zaninotto et al 6 reported 13.2% of reflux recurrence in patients with GERD (6.2% in patients with grade 0 to I esophagitis and 7% in patients with grade-II esophagitis, respectively). Presence of abnormal acid reflux has been reported after Nissen fundoplication as well as after Toupet or cardial calibration in a very similar percentage of cases. 7-9The restoration of the cardial anatomic integrity is followed by a successful outcome after surgery. On the contrary, some authors have published endoscopic or radiologic failures after fundoplication, with defective antireflux wrap associated with a high rate of symptomatic and objective reflux recurrence reaching up to 25% of cases. 2,10The purpose of this prospective study was to correlate the presence of postoperative radiologic and endoscopic defects of the new antireflux barrier after surgery and its association with persistence of symptoms, endoscopic esophagitis, hypotensive LES, and abnormal 24-hour pH monitoring. Patients and Methods Patients studiedIn this prospective ...

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Surgical Treatment of Gastroesophageal Reflux Disease

Dunst

Swanstrom

2012

The Esophagus

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Laparoscopic Reintervention for Failed Antireflux Surgery

Cited by 80 publications

References 30 publications

Surgical Reintervention After Failed Antireflux Surgery: A Systematic Review of the Literature

Surgical Reintervention After Failed Antireflux Surgery: A Systematic Review of the Literature

Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome

Surgical Treatment of Gastroesophageal Reflux Disease

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