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Laparoscopic reoperation for failed antireflux procedures.

M J Curet1, R K Josloff, O Schoeb

  • 1Department of Surgery, University of New Mexico School of Medicine, Albuquerque, USA. mjcuret@unm.edu

Archives of Surgery (Chicago, Ill. : 1960)
|May 14, 1999
PubMed
Summary

Laparoscopic reoperation for recurrent gastroesophageal reflux disease (GERD) is safe and effective. Experienced surgeons can achieve excellent outcomes, offering a viable solution for patients with persistent GERD symptoms after initial surgery.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Laparoscopic fundoplication is the standard surgical treatment for gastroesophageal reflux disease (GERD).
  • Recurrent GERD or dysphagia after antireflux surgery necessitates reevaluation and potential reoperation.
  • Laparoscopic reoperation presents a minimally invasive option for managing complex post-antireflux surgery cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic reoperation for patients with recurrent GERD or dysphagia.
  • To assess the outcomes of patients undergoing revision laparoscopic antireflux surgery.
  • To determine the feasibility of laparoscopic reoperation in a tertiary care setting.

Main Methods:

  • Prospective case series of 27 consecutive patients undergoing attempted laparoscopic reoperation.

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  • Data collection included preoperative symptoms, operative details, and postoperative outcomes (diet, hospitalization, morbidity, mortality).
  • Follow-up ranged from 1 to 60 months postoperatively.

    • Main Results:

    • Twenty-six of 27 patients had successful laparoscopic reoperations with no mortality and minimal morbidity.
    • Most patients resumed a liquid diet by postoperative day 1 and were discharged by day 3.
    • Long-term results were excellent, with no patients requiring acid-reducing medication.

    Conclusions:

    • Laparoscopic reoperation for recurrent GERD is technically challenging but safe and effective.
    • Experienced surgeons can achieve excellent outcomes in patients with failed antireflux surgery.
    • Laparoscopic reoperation should be considered for patients experiencing persistent symptoms after initial antireflux procedures.