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Revisional antireflux surgery

Antônio Moreira Mendes-Filho, Eduardo Sávio Nascimento Godoy, Helga Cristina Almeida Wahnon Alhinho, Manoel Dos Passos Galvão-Neto, Almino Cardoso Ramos, Álvaro Antônio Bandeira Ferraz, Josemberg Marins Campos
Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. OBJECTIVE: To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux. METHODS: Literature review was conducted between July to October 2016 in Medline database, using the following search strategy: ("Gastric bypass" OR "Roux-en-Y") AND ("Fundoplication" OR "Nissen ') AND ("Reoperation" OR "Reoperative" OR "Revisional" OR "Revision" OR "Complications")...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Örs Péter Horváth, Gábor Varga, Zsanett Biró, András Papp, Laura Bognár, András Vereczkei
Laparoscopic antireflux surgery is an effective treatment for patients with gastro-esophageal reflux disease, when it is refractory to conservative management. In experienced centers the procedure is safe, although complications may develop either during surgery or in the early or late postoperative period, which may necessitate revisional surgery. Between 1998 and 2015 a total of 407 patients underwent laparoscopic antireflux surgery at the Department of Surgery, University of Pécs. This interval was divided into two periods...
September 2016: Magyar Sebészet
Luigi Bonavina, Stefano Siboni, Greta I Saino, Demetrio Cavadas, Italo Braghetto, Attila Csendes, Owen Korn, Edgar J Figueredo, Lee L Swanstrom, Eelco Wassenaar
This paper includes commentaries on outcomes of esophageal surgery, including the mechanisms by which fundoduplication improves lower esophageal sphincter (LES) pressure; the efficacy of the Linx™ management system in improving LES function; the utility of radiologic characterization of antireflux valves following surgery; the correlation between endoscopic findings and reported symptoms following antireflux surgery; the links between laparoscopic sleeve gastrectomy and decreased LES pressure, endoscopic esophagitis, and gastroesophageal reflux disease (GERD); the less favorable outcomes following fundoduplication among obese patients; the application of bioprosthetic meshes to reinforce hiatal repair and decrease the incidence of paraesophageal hernia; the efficacy of endoluminal antireflux procedures, and the limited efficacy of revisional antireflux operations, underscoring the importance of good primary surgery and diligent work-up to prevent the necessity of revisional procedures...
October 2013: Annals of the New York Academy of Sciences
Biswanath P Gouda, Thomas Nelson, Sunil Bhoyrul
Surgical myotomy is the gold standard in therapy for achalasia, but treatment failures occur and require revisional surgery. A MEDLINE search of peer-reviewed articles published in English from 1970 to December 2008 was performed using the following terms: esophageal achalasia, Heller myotomy, and revisional surgery. Thirty-three articles satisfied our inclusion criteria. A total of 12,727 patients, with mean age of 43.3 years (males 46% and females 50%), underwent Heller myotomy (open 94.8% and laparoscopic 5...
August 2012: Indian Journal of Surgery
Kyle A Perry, John G Linn, Jeffery L Eakin, Raymond P Onders, Vic Velanovich, W Scott Melvin
INTRODUCTION: Transoral incisionless fundoplication (TIF) has been used for endoscopic treatment of gastroesophageal reflux disease (GERD). Full-thickness polypropylene H-fasteners create a serosa-to-serosa gastroesophageal plication. A certain subset of TIF patients will require subsequent antireflux surgery to achieve adequate reflux control, and it is unknown whether this procedure increases the technical difficulty of laparoscopic Nissen fundoplication for recurrent GERD. PATIENTS AND METHODS: Between 2008 and 2010, patients demonstrating objective evidence of recurrent gastroesophageal reflux following TIF using the Esophyx device (Endogastric Solutions, Redmond, WA) underwent laparoscopic Nissen fundoplication...
May 2013: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Bart P L Witteman, Boudewijn F Kessing, Gitte Snijders, Ger H Koek, José M Conchillo, Nicole D Bouvy
BACKGROUND: Transoral incisionless fundoplication (TIF), a novel endoscopic procedure for treating gastroesophageal reflux disease (GERD), currently is under evaluation. In case of treatment failure, subsequent revisional laparoscopic antireflux surgery (rLARS) may be required. This study aimed to evaluate the feasibility, safety, and outcomes of revisional antireflux surgery after previous endoscopic fundoplication. METHODS: Chronic GERD patients who underwent rLARS after a previous TIF procedure were included in the study...
June 2013: Surgical Endoscopy
C Engström, W Cai, T Irvine, P G Devitt, S K Thompson, P A Game, J R Bessell, G G Jamieson, D I Watson
BACKGROUND: There are few reports of large patient cohorts with long-term follow-up after laparoscopic antireflux surgery. This study was undertaken to evaluate changes in surgical practice and outcomes for laparoscopic antireflux surgery over a 20-year period. METHODS: A standardized questionnaire, prospectively applied annually, was used to determine outcome for all patients undergoing laparoscopic fundoplication in two centres since commencing this procedure in 1991...
October 2012: British Journal of Surgery
Huiqi Yang, Cindy Meun, Xiangyu Sun, David I Watson
BACKGROUND: Some patients develop troublesome dysphagia after laparoscopic antireflux surgery, and a proportion require further intervention. The management of this problem was evaluated. METHODS: Patients who underwent intervention for dysphagia after laparoscopic fundoplication were identified from a database. Outcomes were prospectively determined from a standardized questionnaire that evaluated symptoms scores for dysphagia for solids and liquids, as well as patient satisfaction with the overall outcome...
April 2012: World Journal of Surgery
Sandeepa Musunuru, Jon C Gould
BACKGROUND: Anatomic failure with recurrent gastroesophageal reflux disease (GERD) or related symptoms following fundoplication is a well-described occurrence. Occasionally, reoperative surgery is required. The morbidity of revisional surgery can be quite high, and the clinical outcomes may not be as good as is observed following primary antireflux operations. METHODS: Data were obtained from a prospectively maintained foregut surgery database and via follow-up survey...
March 2012: Surgical Endoscopy
Nicholas R A Symons, Sanjay Purkayastha, Bruno Dillemans, Thanos Athanasiou, George B Hanna, Ara Darzi, Emmanouil Zacharakis
BACKGROUND: Laparoscopic antireflux surgery is an accepted treatment for persistent gastroesophageal reflux but about 4% of patients will eventually require revision surgery. METHODS: We searched The Cochrane Collaboration, Medline, and EMBASE databases, augmented by Google Scholar and PubMed related articles from January 1, 1990, to November 22, 2010. Twenty studies met the inclusion criteria, reporting on 930 surgeries. RESULTS: The mean surgical duration was 166 minutes and conversion to open revision fundoplication was required in 7% of cases...
September 2011: American Journal of Surgery
C A Gutschow, W Schröder, M Bludau, D Vallböhmer, K L Prenzel, E Bollschweiler, A H Hölscher
BACKGROUND: Failure of conventional antireflux surgery is a challenging problem. This study aims at defining the role of distal gastrectomy with Roux-en-Y diversion in the treatment of failed fundoplication. MATERIAL AND METHODS: This report reviews the indications and results of 26 patients who underwent revisional antireflux surgery in our department. Distal gastrectomy and Roux-en-Y reconstruction were performed in 6 patients (group a), refundoplication in 15 (group b), and re-hiatoplasty in 5 patients (group c)...
June 2011: Zentralblatt Für Chirurgie
Chike V Chukwumah, Jeffrey L Ponsky
The outcome and morbidity of revisional surgery after antireflux surgery has been suggested to be suboptimal compared with primary repair. Therefore, an individualized therapeutic approach based on exact analysis of the reasons for failure of the initial procedure is essential for successful management of these patients. This study attempts to summarize the management of this challenging patient population with a focus on the clinical presentation, causes of failure, evaluation, and variety and choice of revisional techniques...
October 2010: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Abdulzahra Hussain, Hind Mahmood, Jackie Nicholls, Shamsi El-Hasani
BACKGROUND: Laparoscopic antireflux surgery has passed the test of time to prove its efficacy and advantage over the traditional approach. Several modifications of the original Nissen fundoplication have been introduced and practiced by surgeons with variable outcomes. METHODS: This modified technique of laparoscopic fundoplication, which we use, is basically a spiral wrap. It is constructed by using several specifically located Ethibond stitches to keep the gastroesophageal junction and a length of the esophagus inside the abdomen without esophageal stitching...
June 2010: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Plauto E Beck, David I Watson, Peter G Devitt, Philip A Game, Glyn G Jamieson
BACKGROUND: It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any differences in outcome might help patient selection and, hence, surgical outcomes. Therefore, in this study we investigated the impact of gender and age on longer-term clinical outcomes following laparoscopic fundoplication...
December 2009: World Journal of Surgery
P J Lamb, J C Myers, G G Jamieson, S K Thompson, P G Devitt, D I Watson
BACKGROUND: A small proportion of patients who have laparoscopic antireflux procedures require revisional surgery. This study investigated long-term clinical outcomes. METHODS: Patients requiring late revisional surgery following laparoscopic fundoplication for gastro-oesophageal reflux were identified from a prospective database. Long-term outcomes were determined using a questionnaire evaluating symptom scores for heartburn, dysphagia and satisfaction. RESULTS: The database search found 109 patients, including 98 (5...
April 2009: British Journal of Surgery
F A Granderath, U M Granderath, R Pointner
BACKGROUND: Failure of hiatal closure has proven to be the most frequent complication leading to revisional surgery after primary failed open or laparoscopic antireflux surgery. To prevent hiatal hernia recurrence some authors recommend the use of prosthetic meshes for reinforcement of the hiatal crura. The aim of the present prospective study was to evaluate the safety and effectiveness of a circular hiatal onlay mesh prosthesis applied during laparoscopic refundoplication after primary failed antireflux surgery with intrathoracic wrap migration...
June 2008: World Journal of Surgery
I Braghetto, K Papapietro, A Csendes, J Gutierrez, P Fagalde, E Diaz, A Rodriguez, F Undurraga
During the last years we have employed acid-suppression duodenal diversion procedures (truncal vagotomy-partial gastrectomy plus Roux-en-Y gastrojejunostomy) in addition to antireflux surgery in order to treat all the pathophysiological factors involved in the genesis of Barrett's esophagus. We have observed very good results concerning the clinical and objective control of GERD at the long-term follow up after this procedure. However, it could be associated with other nonesophageal symptoms or side-effects...
2005: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
J P Byrne, B M Smithers, L K Nathanson, I Martin, H S Ong, D C Gotley
BACKGROUND: The aim was to determine symptomatic and functional outcome after reoperative antireflux surgery for recurrent reflux, persistent dysphagia and severe gas bloat, using a primarily laparoscopic surgical approach. METHODS: This was a retrospective analysis of prospectively collected data from 118 patients, of whom 70 had reoperative surgery for recurrent reflux, 35 for dysphagia and 13 for gas bloat. DeMeester scores before and 1 year after surgery, functional symptoms after surgery and overall patient satisfaction were analysed...
August 2005: British Journal of Surgery
Donald E Low, Trisha Unger
BACKGROUND: Surgical repair of paraesophageal hernias (PEH) remains a challenging operation. Increasing numbers of patients are undergoing laparoscopic repair. This series provides an up-to-date benchmark of the results of open repair of PEH to compare with current laparoscopic series. METHODS: All patients undergoing surgical repair of PEH by a single surgeon between April 1996 and November 2001 were included. Follow-up included postoperative SF-36 survey and objective reassessment (barium swallow or endoscopy) at a mean of 29...
July 2005: Annals of Thoracic Surgery
R J Baigrie, S N R Cullis, A J Ndhluni, A Cariem
BACKGROUND: This double-blind, randomized study compared outcomes of laparoscopic Nissen total fundoplication and anterior partial fundoplication carried out by a single surgeon in a private practice. METHODS: All patients with proven gastro-oesophageal reflux disease, regardless of motility, presenting for laparoscopic antireflux surgery were randomized to either Nissen total or anterior partial fundoplication. Primary outcome measures were dysphagia and abolition of reflux...
July 2005: British Journal of Surgery
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