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Revista Cubana de Cirugía
On-line version ISSN 1561-2945
Abstract
MARTINEZ ALFONSO, Miguel Ángel; ROQUE GONZALEZ, Rosalba; JIMENEZ RAMOS, Raúl and PEREIRA FRAGA, Jorge Gerardo. Reinterventions for Failed Antireflux Surgery. Rev Cubana Cir [online]. 2019, vol.58, n.1 Epub June 30, 2019. ISSN 1561-2945.
Introduction:
Nowadays, laparoscopic fundoplication is considered the treatment of choice for gastroesophageal reflux disease, showing excellent results in more than 90 % of patients. However, despite these results, 30 % of patients present with persistent symptoms, while 3 % to 10 % require reintervention for failed antireflux surgery.
Objective:
To describe the causes of failed antireflux surgery and the techniques performed in the reintervention.
Method:
A descriptive, retrospective and longitudinal study was conducted with a series of patients who underwent antireflux surgery at the National Center for Minimally Access Surgery, from January 1994 to December 2016. The variables analyzed were reinterventions and their causes, surgical treatment, morbidity and the conversion rate.
Results:
From among 1550 patients operated on, 37 (2.3 %) were reintervened. The most frequent causes of reintervention were the recurrence of symptoms and the occurrence of dysphagia. The fundoplication herniation was the most frequent transoperative finding. The conversion rate was low and there were no deaths in the reinterventions. The morbidity tripled that of the total of the series, as well as hospital stay.
Conclusions:
Reinterventions for failed antireflux surgery are very complex, since they increase morbidity and hospital stay considerably. It must be performed in centers that accumulate a high experience in these techniques.
Keywords : reinterventions; esophageal hiatus; antireflux surgery; gastroesophageal reflux disease; fundoplication.