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Reoperation for failed antireflux surgery.

C J Martin1, P F Crookes

  • 1University Department of Surgery, St Vincent's Hospital, Fitzroy, Victoria.

The Australian and New Zealand Journal of Surgery
|October 1, 1990
PubMed
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Reoperation for failed antireflux surgery can achieve good outcomes. Pre-operative diagnosis of the cause of failure, such as a slipped Nissen fundoplication, and wide surgical exposure are key to success.

Area of Science:

  • Gastroenterology
  • Surgical Innovation

Background:

  • Management of failed antireflux surgery presents challenges.
  • Medical interventions often fail in these cases.

Purpose of the Study:

  • To evaluate the efficacy of reoperation for failed antireflux surgery.
  • To identify common causes of antireflux surgery failure.

Main Methods:

  • Ten patients with failed antireflux surgery underwent reoperation.
  • Pre-operative diagnostics included endoscopy, radiology, manometry, and 24-hour pH monitoring.
  • A thoraco-abdominal approach was utilized.

Main Results:

  • The most frequent cause of failure was a slipped Nissen fundoplication.
  • Other causes included tight, disrupted, or herniated fundoplications.

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  • Nine out of ten patients achieved a good outcome post-reoperation.

    • Conclusions:

    • Reoperation for failed antireflux surgery can be successful.
    • Thorough pre-operative assessment to define the cause of failure is crucial.
    • Adequate surgical exposure improves reoperation outcomes.