Reoperative Antireflux Surgery

Grover, Brandon T.; Kothari, Shanu N.

doi:10.1016/j.suc.2015.02.014

Cited by 45 publications

(29 citation statements)

References 42 publications

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“…[15,21,22] This may be the result of inadequate closure of the diaphragmatic crura or rupture of the crural sutures used to close the hiatal ring or disruption of the muscle fibers due to vomiting during the early or late period. [12,17] In the present study, this rate was also detected as 65.1%.…”

Section: Discussionsupporting

confidence: 76%

“…[1,4,5] However, short- and long-term reflux recurrences following surgical treatment still remain a serious problem. [12] In the literature, long-term success rates up to 5 years after surgery are as high as 90%; but even operative failure and reoperative intervention for primary antireflux surgery range from 3% to 6%. [6–8,12–17] Despite the good results reported after laparoscopic fundoplication, a multicentric trial showed that 62% of the patients continued to use antireflux medications regularly after the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[12] In the literature, long-term success rates up to 5 years after surgery are as high as 90%; but even operative failure and reoperative intervention for primary antireflux surgery range from 3% to 6%. [6–8,12–17] Despite the good results reported after laparoscopic fundoplication, a multicentric trial showed that 62% of the patients continued to use antireflux medications regularly after the surgery. [18] Postoperative proton pump inhibitors (PPI) dependence cannot be taken as the sole indicator of the recurrence, as many patients continue to take PPI preparations to relieve dysphagia, gas bloat, and other dyspeptic symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The diaphragm is constantly mobile with respiration, vomiting, laughing, and straining, and also high tension and mobility of the tissue can cause a disruption in these muscle bundles of the crura. [4,12] The most frequent pattern of fundoplication failure is anatomic, which includes wrap failure, hiatus failure, paraesophageal hernia, or slipped Nissen. The primary etiologies of recurrence remain crural breakdown and the short esophagus.…”

Section: Discussionmentioning

confidence: 99%

“…The primary etiologies of recurrence remain crural breakdown and the short esophagus. [6,12,13,20] In reported series, wrap herniation with or without hiatal disruption was the most common intraoperative finding, observed in up to 54% at the time of the redo operation. [15,21,22] This may be the result of inadequate closure of the diaphragmatic crura or rupture of the crural sutures used to close the hiatal ring or disruption of the muscle fibers due to vomiting during the early or late period.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Laparoscopic revision surgery for gastroesophageal reflux disease

Celasin

Genç²,

Çelik³

et al. 2017

Medicine

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Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of gastroesophageal reflux in surgical clinics. Reflux can recur in between 3% and 30% of patients on whom antireflux surgery has been performed, and so revision surgery can be required due to recurrent symptoms or dysphagia in approximately 3% to 6% of the patients. The objective of this study is to evaluate the mechanism of recurrences after antireflux surgery and to share our results after revision surgery in recurrent cases.From 2001 to 2014, revision surgery was performed on 43 patients (31 men, 12 women) between the ages of 24 and 70 years. The technical details of the first operation, recurrence symptoms, endoscopy, and manometry findings were evaluated. The findings of revision surgery, surgical techniques, morbidity rates, length of hospitalization, and follow-up period were also recorded and evaluated.The first operation was Nissen fundoplication in 34 patients and Toupet fundoplication in 9 patients. Mesh hiatoplasty was performed for enforcement in 18 (41.9%) of these patients. The period between the first operation and the revision surgery ranged from 4 days to 60 months. The most common finding was slipped fundoplication and presence of hiatal hernia during revision surgery. Revision fundoplication and hernia repair with mesh reinforcement were used in 33 patients. The other techniques were Collis gastroplasty, revision fundoplication, and hernia repair without mesh. The range of follow-up period was from 2 to 134 months. Recurrence occurred in 3 patients after revision surgery (6.9%). Although revision surgery is difficult and it has higher morbidity, it can be performed effectively and safely in experienced centers.

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