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Reoperation after antireflux surgery: a population-based cohort study
J S Ljungdalh1,2, K H Rubin3, J Durup4
1Departments of Surgery, Kolding, Denmark.
The British Journal of Surgery
|June 3, 2020
Summary
Reoperation after antireflux surgery for gastro-oesophageal reflux disease (GORD) occurs in 12.8% of patients within 15 years. Repeat surgeries are linked to increased complications, highlighting the need for careful consideration.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Public Health
Background:
- Antireflux surgery is effective for gastro-oesophageal reflux disease (GORD) and hiatal hernia.
- 10-20% of patients require reoperation for recurrent symptoms.
- Previous studies may underestimate reoperation rates due to single-center designs.
Purpose of the Study:
- To determine long-term reoperation rates after antireflux surgery.
- To assess complications associated with repeat antireflux procedures.
- To analyze the impact of endoscopic dilatation on reoperation rates.
Main Methods:
- Nationwide population-based cohort study in Denmark (2000-2017).
- Inclusion of patients undergoing primary antireflux surgery and reoperations.
- Calculation of reoperation rates at 1, 5, 10, and 15 years.
Main Results:
- 12.8% of patients underwent reoperation within 15 years.
- Repeat antireflux surgery had higher complication rates (7.0% at 30 days, 8.3% at 90 days) compared to primary surgery (3.4% and 4.8%).
- 391 patients (10.5%) had endoscopic dilatation, with 24.3% of these requiring repeat surgery.
Conclusions:
- The 15-year reoperation rate after antireflux surgery is 12.8%.
- Reoperations are associated with a higher incidence of complications.
- Endoscopic dilatation may be a precursor to reoperation in some cases.
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