Redo Antireflux Surgery after Failed Fundoplication

  • Ion C. PUIA “Iuliu Hatieganu” University of Medicine and Pharmacy, Victor Babes Str. 8, Cluj-Napoca (RO)
  • Aida PUIA “Iuliu Hatieganu” University of Medicine and Pharmacy, Victor Babes Str. 8, Cluj-Napoca (RO)
  • Sebastian GHEORGHIU “Iuliu Hatieganu” University of Medicine and Pharmacy, Victor Babes Str. 8, Cluj-Napoca
  • Paul G. CRISTEA “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, 3rd General Surgery Clinic, Croitorilor Str. 19-21, Cluj-Napoca (RO)

Abstract

Redo antireflux surgery is an advanced surgical procedure which encompasses the following usual steps: takedown of the previous fundoplication, repair of the hiatal defect followed by the actual antireflux procedure. The aim of our extensive review of current relevant literature is to discuss the indications, techniques, complications and limitations of this surgery. In reoperations, a great percentage of surgeons favor the short floppy Nissen, although partial plications or gastrojejunostomies are also practiced. A shortened esophagus is usually one of several causes for reflux reoccurrence, and requires either an extended periesophageal dissection or a Collis gastroplasty. The surface of the hiatal defect, rather than its diameter, is the most important indication for repair. Many repair variants have been introduced and tested, showing that antireflux surgery is still awaiting ideal prosthetic material, whereas details regarding tailoring, placement and suturing of current meshes are subjects of debate. The most frequent complication is gastric perforation; others include pulmonary or cardiac failure, infections, and acute pancreatitis. Mortality approaches 1% with a procedure success rate of 80%. Thus, due to its complexity and challenges, redo antireflux surgery should be performed by an experienced team in a tertiary center to increase its success rate.

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Published
2016-12-16
How to Cite
PUIA, I. C., PUIA, A., GHEORGHIU, S., & CRISTEA, P. G. (2016). Redo Antireflux Surgery after Failed Fundoplication. Notulae Scientia Biologicae, 8(4), 387-392. https://doi.org/10.15835/nsb849930
Section
Review articles
CITATION
DOI: 10.15835/nsb849930

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