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Laparoscopic reoperation following failed antireflux surgery
D I Watson1, G G Jamieson, P A Game
1University Department of Surgery, Royal Adelaide Hospital, South Australia, Australia.
The British Journal of Surgery
|February 23, 1999
Summary
Laparoscopic revision surgery for failed antireflux operations is feasible, offering good outcomes for most patients. However, reoperation after open surgery presents greater challenges than after laparoscopic procedures.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Antireflux surgery aims to correct gastroesophageal reflux disease (GERD).
- Previous open or laparoscopic antireflux operations may require revision due to recurrence or complications.
- Assessing the feasibility of laparoscopic revision is crucial for patient management.
Purpose of the Study:
- To evaluate the feasibility and outcomes of laparoscopic revision surgery after prior open or laparoscopic antireflux procedures.
- To compare the difficulty and success rates of laparoscopic reoperation following open versus laparoscopic index procedures.
Main Methods:
- A cohort of 27 patients undergoing laparoscopic revision for antireflux surgery was analyzed.
- Patients had a history of either open (13) or laparoscopic (14) antireflux operations.
- Follow-up was conducted for a median of 12 months to assess outcomes and complications.
Main Results:
- Laparoscopic revision was successfully completed in 21 out of 27 patients (12 after laparoscopic, 9 after open surgery).
- Indications included recurrent reflux (15), paraesophageal hernia (6), and dysphagia (6).
- No perioperative complications were reported, and 25 patients achieved a good outcome.
Conclusions:
- Laparoscopic reoperative antireflux surgery is a feasible approach.
- Reoperation is technically more demanding and potentially less successful after a failed open antireflux procedure compared to a laparoscopic one.