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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Reoperative antireflux surgery.

Brandon T Grover1, Shanu N Kothari1

  • 1Department of General and Vascular Surgery, Gundersen Health System, 1900 South Avenue, C05-001, La Crosse, WI 54601, USA.

The Surgical Clinics of North America
|May 13, 2015
PubMed
Summary
This summary is machine-generated.

Reoperation for failed antireflux surgery is sometimes needed due to issues like slipped fundoplication. Converting to Roux-en-Y anatomy offers a successful surgical option for recurrent reflux and dysphagia.

Keywords:
Collis gastroplastyGastroesophageal reflux diseaseNissen fundoplicationOutcomesPreoperative evaluationRevisional surgeryRoux-en-Y gastric bypass

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Primary antireflux surgery generally yields high patient satisfaction.
  • A subset of patients experience recurrent symptoms (reflux, dysphagia) post-surgery, necessitating reoperation.
  • Common causes of failed fundoplication include slipped wraps, unrecognized short esophagus, and technical wrap issues.

Purpose of the Study:

  • To review the causes of failed primary antireflux surgery.
  • To discuss surgical options for reoperation, including redo fundoplication, conversion to Roux-en-Y, and esophagectomy.
  • To highlight the efficacy of Roux-en-Y conversion in selected patients.

Main Methods:

  • Review of literature on failed fundoplication and reoperative strategies.
  • Analysis of outcomes for different surgical revision techniques.
  • Focus on minimally invasive approaches for revisional surgery.

Main Results:

  • Minimally invasive techniques are increasingly utilized for antireflux surgery revisions.
  • Redo fundoplication with hiatal hernia repair is one option.
  • Conversion to Roux-en-Y anatomy demonstrates a high success rate for managing failed fundoplication.

Conclusions:

  • Recurrent reflux and dysphagia after primary antireflux surgery can stem from specific anatomic failures.
  • Surgical revision options are available, with Roux-en-Y conversion being a successful strategy for carefully selected patients.
  • Minimally invasive approaches enhance revisional antireflux surgery, offering improved outcomes.