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Re-operation for failed anti-reflux surgery
J K Lim1, E Moisidis, W S Munro
1Department of Surgery, Concord, Strathfield Adventist Hospital, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|November 1, 1996
Summary
Re-operative anti-reflux surgery, primarily transabdominal Nissen fundoplication, shows good outcomes. This approach offers acceptable complication rates and excellent symptom relief for patients with failed previous anti-reflux procedures.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Outcomes
Background:
- 315 anti-reflux procedures performed between 1993-1995.
- 10% of patients (31) had prior anti-reflux surgery, predominantly Nissen fundoplication (80%).
Purpose of the Study:
- To evaluate the outcomes of re-operative anti-reflux surgery.
- To identify causes of failure in previous anti-reflux procedures.
Main Methods:
- Pre-operative diagnostics included manometry, 24h pH monitoring, oesophagoscopy, and barium radiology.
- Transabdominal approach used in 94% of re-operations.
- Complication rate was 16%.
Main Results:
- Causes of failure identified: hiatal (65%), oesophageal dysmotility (10%), and fundoplication (25%).
- 91% of patients reported good to excellent symptomatic outcomes at a mean 21-month follow-up.
Conclusions:
- Transabdominal re-operative anti-reflux surgery is effective.
- The procedure demonstrates an acceptable complication rate and favorable medium-term symptomatic results.