[Radiographic patterns in patients after antireflux surgery]

Area of Science:

• Gastroenterology
• Surgical Imaging
• Radiology

Background:

• Anti-reflux surgery, including fundoplication, is increasingly performed for gastroesophageal reflux disease.
• Laparoscopic techniques have expanded patient selection for surgical intervention.
• Post-operative monitoring is crucial for assessing surgical success and identifying complications.

Purpose of the Study:

• To evaluate the diagnostic accuracy of radiologic examinations of the esophagus and stomach.
• To identify normal radiographic patterns following anti-reflux procedures.
• To detect surgical complications and causes of treatment failure after fundoplication.

Main Methods:

• Radiographic review of 11 patients (5 men, 6 women) who underwent fundoplication (Nissen, Belsey-Mark IV, Toupet, Dor).
• Procedures included 4 laparoscopic and 7 open surgeries.
• Single and/or double contrast techniques with barium sulfate were used, with radiographs taken in multiple positions.

Main Results:

• Five patients experienced complications: tight fundoplication (1), broken/migrated fundoplication (2), and loosened/migrated fundoplication (2).
• In the remaining 6 patients, barium passage and fundoplication position were normal.
• Radiography identified specific complications such as fundoplication tightness, migration, and loosening.

Conclusions:

• Radiographic examination of the esophagus and stomach remains an effective tool for follow-up after anti-reflux surgery.
• While successful symptom relief is high (90%), complications occur in less than 10% of cases.
• Imaging aids in diagnosing complications and understanding treatment failures, guiding patient management.