Redo Antireflux Surgery after Failed Fundoplication
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 antireï¬‚ux 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.
Distribution - Permissions - Copyright
Papers published in Notulae Scientia Biologicae are Open-Access, distributed under the terms and conditions of the Creative Commons Attribution License.
© Articles by the authors; licensee SHST, Cluj-Napoca, Romania. The journal allows the author(s) to hold the copyright/to retain publishing rights without restriction.
Open Access Journal - the journal offers free, immediate, and unrestricted access to peer-reviewed research and scholarly work, due SHST supports to increase the visibility, accessibility and reputation of the researchers, regardless of geography and their budgets. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author.