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2021, Number 3-4

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Rev Mex Cir Endoscop 2021; 22 (3-4)

Reoperation in failed antireflux surgery: cohort study and proposal of a systematized surgical approach

Decanini-Terán CO, Maldonado-García EL, Vega-de JM, Fournier-Montemayor FJ, Estrada-Gómez RA, González-Macedo E, Obregón-Méndez JG

Language: Spanish
References: 26
Page: 121-127
PDF size: 301.92 Kb.


ABSTRACT

With approach to anti-reflux surgery, the number of fundoplications increased substantially in the last 25 years and with this, the number of failed fundoplications increased. Refundoplication surgery has a high morbidity rate. Objective: Analyze the experience of laparoscopic refundoplications and the advantages granted by the systematized surgical approach. Material and methods: Ambispective cohort study of 201 refundoplications performed by a single surgeon with the same surgical technique before and after modifications over a period of 20 years and four months. Demographic and perioperative characteristics were analyzed. Results: The most frequent symptoms were dysphagia and reflux. A mean surgical time of 135.1 ± 10.2 minutes was obtained, mean hospital stay of 2.6 ± 0.8 days and a mean follow-up of 37.7 ± 4.7 months. The warned pneumothorax was presented as the most frequent complication (n = 10, 4.9%). Modifications made to the surgical technique clearly decreased postoperative dysphagia and persistent reflux (p < 0.05). Conclusions: Systematization in the surgical technique in refundoplication reduces surgical time and morbidity. Transoperative endoscopy, which is of vital importance for performing a fundoplication, should be considered as a sine qua non condition in refundoplications.


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