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Post Nissen syndrome
D E Low1, C D Mercer, E C James
1Department of Surgery, Virginia Mason Medical Center, Seattle, Washington.
Surgery, Gynecology & Obstetrics
|July 1, 1988
Summary
Reoperation for severe Nissen fundoplication complications, like reflux and dysphagia, can be successful. The Hill antireflux procedure offered good to excellent outcomes in 86% of patients needing revision surgery.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Outcomes
Background:
- Nissen fundoplication is a common anti-reflux surgery.
- Complications such as gas bloat and inability to vomit can occur.
- Serious complications may necessitate reoperation.
Purpose of the Study:
- To classify causes of Nissen repair failure.
- To evaluate reoperation outcomes for severe complications.
- To assess the efficacy of the Hill antireflux procedure in revisions.
Main Methods:
- Retrospective review of 116 patients requiring reoperation after Nissen fundoplication.
- Classification of complications based on failed repair.
- Analysis of outcomes following reoperation, primarily with the Hill procedure.
Main Results:
- Recurrent reflux (86%), severe dysphagia (60%), and esophageal dysmotility (48%) were common reasons for reoperation.
- Gastric perforation and fistulization occurred in 5% of cases.
- The Hill antireflux procedure yielded excellent or good results in 86% of reoperations.
Conclusions:
- Reoperation for severe Nissen fundoplication complications is often necessary.
- The Hill antireflux procedure demonstrates high success rates in revising failed Nissen repairs.
- Careful patient selection and surgical technique are crucial for managing Nissen repair failures.