medigraphic.com
ISSN 1561-2945 (Print)

2019, Number 1

<< Back Next >>

Revista Cubana de Cirugía 2019; 58 (1)

Reinterventions for failed Antireflux surgery

Martínez AMÁ, Roque GR, Jiménez RR, Pereira FJG

Language: Spanish
References: 19
Page: 46-54
PDF size: 266.53 Kb.


ABSTRACT

Introduction: Nowadays, laparoscopic fundoplication is considered the treatment of choice for gastroesophageal reflux disease, showing excellent results in more than 90 % of patients. However, despite these results, 30 % of patients present with persistent symptoms, while 3 % to 10 % require reintervention for failed antireflux surgery.
Objective: To describe the causes of failed antireflux surgery and the techniques performed in the reintervention.
Method: A descriptive, retrospective and longitudinal study was conducted with a series of patients who underwent antireflux surgery at the National Center for Minimally Access Surgery, from January 1994 to December 2016. The variables analyzed were reinterventions and their causes, surgical treatment, morbidity and the conversion rate.
Results: From among 1550 patients operated on, 37 (2.3 %) were reintervened. The most frequent causes of reintervention were the recurrence of symptoms and the occurrence of dysphagia. The fundoplication herniation was the most frequent transoperative finding. The conversion rate was low and there were no deaths in the reinterventions. The morbidity tripled that of the total of the series, as well as hospital stay.
Conclusions: Reinterventions for failed antireflux surgery are very complex, since they increase morbidity and hospital stay considerably. It must be performed in centers that accumulate a high experience in these techniques.


REFERENCES

  1. del Campo SEM, Mansfield SA, Suzo AJ, Hazey JW, Perry KA. Laparoscopic redo fundoplication improves disease-specific and global quality of life following failed laparoscopic or open fundoplication. Surg Endosc [Internet]. 2017[cited 2018 Mar 6]; 31(11):4649-55. Available from: https://doi.org/10.1007/s00464-017-5528-7.

  2. Singhal S, Kirkpatrick DR, Masuda T, Gerhardt J, Mittal SK. Primary and Redo Antireflux Surgery: Outcomes and Lessons Learned. J Gastrointest Surg. 2018;22(2):177-86.

  3. Obeid NR, Altieri MS, Yang J, Park J, Price K, Bates A, et al. Patterns of reoperation after failed fundoplication: an analysis of 9462 patients. Surg Endosc. 2018;32(1):345-50.

  4. Nageswaran H, Haque A, Zia M, Hassn A. Laparoscopic redo anti-reflux surgery: Case-series of different presentations, varied management and their outcomes. Int J Surg [Internet]. 2017 [Cited 2018 Mar 6];6:47-52. Available from: http://www.science direct.com/science/article/pii/S1743919117312128

  5. Banki F, Kaushik C, Roife D, Chawla M, Casimir R, Miller CC. Laparoscopic reoperative antireflux surgery: A safe procedure with high patient satisfaction and low morbidity. Am J Surg [Internet]. 2016 [cited 2018 Mar 6];212(6):1115-20. Available from: http://www.sciencedirect.com/science/article/pii/S0002961016305578.

  6. Obeid NR, Altieri MS, Yang J, Park J, Price K, Bates A, et al. Patterns of reoperation after failed fundoplication: an analysis of 9462 patients. Surg Endosc [Internet]. 2018[cited 2018 Mar 6];32(1):345-50. Available from: https://doi.org/10.1007/s00464-017-5682-y.

  7. Martínez MA. Enfermedad por reflujo gastroesofágico. Tratamiento laparoscópico. En: Ruiz T, Torres R, Martínez MA, Fernández A, Pascual H. Cirugía endoscópica. Fundamentos y aplicaciones. La Habana: Editorial Científico-Técnica; 1998. p. 141-7.

  8. Richter JE. Gastroesophageal reflux disease treatment: side effects and complications of fundoplication. Clin Gastroenterol Hepatol [Internet]. 2013 [cited 2018 Mar 5];11(5):465-71. Available from: https://doi.org/10.1016/j.cgh.2012.12.006

  9. Smith CD. Reoperative Antireflux Surgery. In: Swanstrom LL, Dunst CM, editors. Antireflux Surgery. New York, NY: Springer New York; 2015. p. 205-18.

  10. Yano F, Omura N, Tsuboi K, Hoshino M, Yamamoto SR, Akimoto S, et al. Outcomes of redo surgery for failed laparoscopic fundoplication. Esophagus [Internet]. 2016 [cited 2018 Mar 6];13(3):[290-4 pp.]. Available from: https://doi.org/10.1007/s10388-016-0532-x.

  11. Wykypiel H, Kamolz T, Steiner P, Klingler A, Granderath FA, Pointner R, et al. Austrian experiences with redo antireflux surgery. Surg Endosc [Internet]. 2005 [cited 2018 Mar 5];19(10):1315-9. Available from: https://doi.org/10.1007/s00464-004-2208-1.

  12. Funch-Jensen P, Bendixen A, Iversen MG, Kehlet H. Complications and frequency of redo antireflux surgery in Denmark: a nationwide study, 1997-2005. Surg Endosc. 2008;22(3):627-30.

  13. Wee JO. Redo laparoscopic repair of benign esophageal disease. J Thorac Cardiovasc Surg [Internet]. 2012 [cited 2018 Mar 6];144(3):S71-S3. Available from: http://www.sciencedirect.com/science/article/pii/S0022522312004230.

  14. Bonavina L. Reoperation for Failed Antireflux Surgery. In: Fisichella PM, editor. Failed Anti-Reflux Therapy: Analysis of Causes and Principles of Treatment. Cham: Springer International Publishing; 2017. p. 111-20.

  15. Iqbal A, Awad Z, Simkins J, Shah R, Haider M, Salinas V, et al. Repair of 104 failed anti-reflux operations. Ann Surg. 2006;244(1):42-51.

  16. Pennathur A, Awais O, Luketich JD. Minimally invasive redo antireflux surgery: lessons learned. Ann Thorac Surg. 2010;89(6):S2174-9.

  17. Jarral OA, Athanasiou T, Hanna GB, Zacharakis E. Is an intra-oesophageal bougie of use during Nissen fundoplication? Interact Cardiovasc Thorac Surg [Internet]. 2012; 14(6):[828-33 pp.]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3352701/.

  18. Van Beek DB, Auyang ED, Soper NJ. A comprehensive review of laparoscopic redo fundoplication. Surg Endosc. 2011;25(3):706-12.

  19. Decanini Terán C, Vega de Jesús M, Obregón Méndez J, González Acosta J. Reoperación laparoscópica de cirugía antirreflujo. Rev Mex Cir Endosc [Internet]. 2012 [cited 2018 Mar 6];13(1):29-33. Available from: http://www.medigraphic.com/pdfs/ endosco/ce-2012/ce121g.pdf.




2020     |     www.medigraphic.com