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Related Experiment Videos

Austrian experiences with redo antireflux surgery.

H Wykypiel1, T Kamolz, P Steiner

  • 1Department of General and Transplant Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. heinz.wykypiel@uibk.ac.at

Surgical Endoscopy
|October 6, 2005
PubMed
Summary

Redo fundoplications are a viable option for failed antireflux surgery in Austria, but carry higher risks. Experienced surgical departments are crucial for successful outcomes in these complex redo procedures.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Medical Policy Analysis

Background:

  • Laparoscopic fundoplication rates have significantly increased in Austria since 1996.
  • Failed antireflux surgery necessitates redo procedures when medical management is insufficient.
  • A need exists to understand the current landscape and outcomes of redo fundoplications.

Purpose of the Study:

  • To delineate the current policy and practices for redo fundoplications across Austria.
  • To evaluate the postoperative results and complication rates associated with redo fundoplications.
  • To compare outcomes of redo fundoplications with primary antireflux surgeries.

Main Methods:

  • A nationwide questionnaire survey of Austrian surgical departments was conducted in 2003.

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  • Data collected included primary and redo fundoplication numbers, techniques, complications, and patient outcomes.
  • Information on preoperative workup, patient migration, and mortality was also gathered.

    • Main Results:

    • Over 4,500 primary fundoplications were performed, with a majority using laparoscopy.
    • Approximately 225 redo fundoplications were performed, predominantly laparoscopically, with Nissen and partial posterior techniques favored.
    • The redo fundoplication conversion rate was 10.8%, with a mortality rate of 0.4% (all open approach).

    Conclusions:

    • Laparoscopic redo fundoplications are established in Austria following failed primary surgery.
    • Redo procedures exhibit a significantly higher conversion and mortality rate compared to primary fundoplications.
    • Specialized centers with extensive experience are recommended for performing redo fundoplications.