This journal only 2016, Number 3 Rev Mex Cir Endoscop 2016; 17 (3) Experience in laparoscopic re-operation of anti-reflux surgery: Description of technique and long-term results Decanini TC, Estrada GRA, Vega JM, Obregón MJG Full text How to cite this article Language: Spanish References: 23 Page: 139-145 PDF size: 476.66 Kb. Key words: Fundoplication, laparoscopy, reoperation, GERD, complications. ABSTRACT Introduction: Anti-reflux-surgery failure is manifested mainly by dysphagia and Gastro-esophageal reflux symptoms. This clinical presentation frequently drives the physician to request complementary studies. Discussion: The laparoscopic re-operation of the esophageal hiatus is a great surgical challenge. It also carries a high morbidity, high conversion possibilities and less success rate to improve symptoms than primary intervention. Material and method: This is a retrospectives study. Clinical files were reviewed of all patients that went through a surgical re intervention after a laparoscopic anti-reflux surgery during the period from August 1st 1999 to August 31st 2013 at Centro Medico ABC. Multivariate analysis of clinical evolution, Symptoms, cause or mechanism of failure, operative time also trans and postoperative complications. Results: 135 esophageal hiatus re-operations were performed in a period of 14 years. Dysphagia was the main complaint 50% and GERD in 46%. The average interval between the primary anti-reflux surgery and re operation was 26.8 months. The most common complication was left pneumothorax with an index of conversion of 4.4%. The most frequent mechanism of failure was a proximal migrating fundoplication in 41.5%. The average operative time was 129 min. a new Nissen procedure was performed in 77% of the patients and the average hospital stay was 2.9 days. Conclusion: According to available international data esophageal hiatus re-operation is feasible, safe and effective. This is the most extensive study in Latin America and the second worldwide. REFERENCES Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R. Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc. 1991; 1: 138-143. Finks JF, Wei Y, Birkmeyer JD. The rise and fall of antireflux surgery in the United States. Surg Endosc. 2006; 20: 1698-1701. Hunter JG, Smith CD, Branum GD, Waring JP, Trus TL, Cornwell M et al. Laparoscopic fundoplication failures: patterns of failure and response to fundoplication revision. Ann Surg. 1999; 230: 595-604 (discussion 604-596). Lafullarde T, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG. Laparoscopic Nissen fundoplication: five-year results and beyond. Arch Surg. 2001; 136: 180-184. Van Beek DB, Auyang ED, Soper NJ. A comprehensive review of laparoscopic redo fundoplication. Surg Endosc. 2010; 25: 706-712. Symons NR, Purkayastha S, Dillemans B, Athanasiou T, Hanna GB, Darzi A et al. Laparoscopic revision of failed antireflux surgery: a systematic review. Am J Surg. 2011; 202: 336-343. Smith CD. Antireflux surgery. Surg Clin N Am. 2008; 88: 943-958. Decanini TC, Vega JM, Obregón MJ, González AJ. Reoperación laparoscópica de cirugía por reflujo. Rev Mex Cir Endoscop. 2012; 13: 29-33. Horgan S, Pohl D, Bogetti D, Eubanks T, Pellegrini C. Failed antireflux surgery: what have we learned from reoperations? Arch Surg. 1999; 134: 809-817. Curet MJ, Josloff RK, Schoeb O, Zucker KA. Laparoscopic reoperation for failed antireflux procedures. Arch Surg. 1999; 134: 559-563. Iqbal A, Awad Z, Simkins J, Shah R, Haider M, Salinas V, Turaga K et al. Repair of 104 failed anti-reflux operations. Ann Surg. 2006; 244: 42-51. Funch-Jensen P, Bendixen A, Iversen MG, Kehlet H. Complications and frequency of redo antireflux surgery in Denmark: a nationwide study, 1997-2005. Surg Endosc. 2008; 22: 627-630. Hinder RA, Libbey JS, Gorecki P, Bammer T. Antireflux surgery. Indications, preoperative evaluation, and outcome. Gastroenterol Clin North Am. 1999; 28: 987-1005, viii. Oelschlager BK, Lal DR, Jensen E, Cahill M, Quiroga E, Pellegrini CA. Medium and long-term outcome of laparoscopic redo fundoplication. Surg Endosc. 2006; 20: 1817-1823. Coelho JC, Gonçalves CG, Claus CM, Andrigueto PC, Ribeiro MN. Late laparoscopic reoperation of failed antireflux procedures. Surg Laparosc Endosc Percutan Tech. 2006; 14: 113-117. Khajanchee YS, O’Rourke R, Cassera MA, Gatta P, Hansen PD, Swanström LL. Laparoscopic reintervention for failed antireflux surgery: subjective and objective outcomes in 176 consecutive patients. Arch Surg. 2007; 142: 785-901 (discussion 791-782). Byrne JP, Smithers BM, Nathanson LK, Martin I, Ong HS, Gotley DC. Symptomatic and functional outcome after laparoscopic reoperation for failed antireflux surgery. Br J Surg. 2005; 92: 996-1001. Papasavas PK, Yeaney WW, Landreneau RJ, Hayetian FD, Gagné DJ, Caushaj PF et al. Reoperative laparoscopic fundoplication for the treatment of failed fundoplication. J Thorac Cardiovasc Surg. 2005; 128: 509-516. Watson DI, Jamieson GG, Game PA, Williams RS, Devitt PG. Laparoscopic reoperation following failed antireflux surgery. Br J Surg. 1999; 86: 98-101. Hatch KF, Daily MF, Christensen BJ, Glasgow RE. Failed fundoplications. Am J Surg. 2004; 188: 786-791. Safranek PM, Gifford CJ, Booth MI, Dehn TC. Results of laparoscopic reoperation for failed antireflux surgery: does the indication for redo surgery affect the outcome? Dis Esophagus. 2007; 20: 341-345. Luketich JD, Fernando HC, Christie NA, Buenaventura PO, Ikramuddin S, Schauer PR. Outcomes after minimally invasive reoperation for gastroesophageal reflux disease. Ann Thorac Surg. 2002; 74: 328-331 (discussion 331-322). Frantzides CT, Madan AK, Carlson MA, Zeni TM, Zografakis JG, Moore RM et al. Laparoscopic revision of failed fundoplication and hiatal herniorraphy. J Laparoendosc Adv Surg Tech A. 2009; 19: 135-139.