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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
PubMed
Summary
This summary is machine-generated.

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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.

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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.