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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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[Redo surgery after laparoscopic fundoplication].

M V Timerbulatov1, E I Senderovich1, E E Grishina1

  • 1Bashkir State Medical University, Ufa, Russia.

Khirurgiia
|October 19, 2019
PubMed
Summary
This summary is machine-generated.

Redo anti-reflux surgeries effectively improve quality of life for patients with recurrent reflux or dysphagia. Despite technical challenges, these repeat procedures offer significant long-term benefits and safety.

Keywords:
failed fundoplicationpostoperative dysphagiaquality of liferecurrent herniaredo fundoplication

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Laparoscopic fundoplication is a common anti-reflux surgery.
  • Recurrent symptoms or complications may necessitate redo surgery.
  • Understanding outcomes of repeat anti-reflux procedures is crucial.

Purpose of the Study:

  • To analyze the outcomes of redo surgeries following initial laparoscopic fundoplication.
  • To identify causes of unsatisfactory results after primary anti-reflux surgery.
  • To compare redo surgery outcomes with primary anti-reflux surgery.

Main Methods:

  • Retrospective analysis of 37 redo anti-reflux surgeries.
  • Comparison with a control group of 38 patients undergoing primary anti-reflux surgery.
  • Evaluation of causes for initial surgery failure, intraoperative data, and short/long-term results.
  • Quality of life assessment using the GIQLI questionnaire.

Main Results:

  • Recurrent reflux often resulted from hernia recurrence and fundoplication cuff issues.
  • Dysphagia was commonly linked to esophageal compression from diaphragmatic crura or recurrent hernia.
  • Redo surgeries involved longer operating times, hospital stays, and higher complication rates.
  • Significant quality of life improvement was noted in the redo surgery group, attributed to lower baseline scores.

Conclusions:

  • Redo anti-reflux surgeries are effective and safe, offering significant long-term quality of life improvements.
  • Technical difficulties in redo procedures are acknowledged.
  • Persistent dysphagia is often related to diaphragm repair, while reflux recurrence is linked to cuff slippage and hernia recurrence.