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Laparoscopic reoperations after failed and complicated antireflux operations
A L DePaula1, K Hashiba, M Bafutto
1Department of Surgery, Hospital Samaritano, Goiás, Brazil.
Surgical Endoscopy
|June 1, 1995
Summary
Laparoscopic reoperations for failed antireflux surgery are feasible, showing good results in 84.3% of patients. This approach offers a viable solution for recurrent gastroesophageal reflux disease (GERD) after initial anti-reflux operations.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Gastroesophageal reflux disease (GERD) often requires surgical intervention.
- Antireflux operations can fail or lead to complications, necessitating reoperation.
- Laparoscopic surgery is increasingly used for primary and revisional anti-reflux procedures.
Purpose of the Study:
- To evaluate the feasibility and outcomes of laparoscopic reoperations for failed or complicated antireflux surgeries.
- To identify causes of antireflux surgery failure and complications.
- To assess the safety and efficacy of minimally invasive revisional anti-reflux procedures.
Main Methods:
- Retrospective review of 19 patients undergoing laparoscopic reoperation for failed antireflux surgery.
- Analysis of prior surgical history, reasons for reoperation, surgical techniques, and outcomes.
- Laparoscopic reoperations included fundoplications, esophagectomy, and gastrectomy.
Main Results:
- 84.3% of patients achieved excellent or good outcomes after a mean follow-up of 13 months.
- Common causes for reoperation included slipped or disrupted fundoplications and recurrent esophagitis.
- Mean operative time was 210 minutes; mean hospital stay was 3.1 days for failed operations.
Conclusions:
- Laparoscopic reoperations for failed antireflux surgery are technically feasible.
- This approach yields good preliminary results for managing recurrent GERD.
- Sufficient surgical expertise is crucial for successful laparoscopic reoperations.