Failed Antireflux Surgery

Results After Reoperation

Galen A. Ohnmacht, Claude Deschamps, Stephen D. Cassivi, Francis C. Nichols, Mark S. Allen, Cathy D. Schleck, Peter C. Pairolero

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Since laparoscopy has become a common surgical approach for antireflux surgery, little is known regarding reoperation for failed antireflux surgery. Methods: Records of all patients who underwent reoperation without esophageal resection for symptoms of recurrent gastroesophageal reflux disease or hiatal hernia between July 1, 1995 and April 1, 2004 were reviewed. There were 126 patients. Two patients declined research participation. The remaining 124 patients (71 women and 53 men) formed the basis for this study. Median age was 53 years (range, 19 to 83 years). The initial operation was a laparoscopic antireflux procedure in 76 patients (61.3%) and an open repair in 48 (38.7%). A single previous operation had been done in 100 patients, two operations in 20, and three operations in 4. The median interval between the most recent reoperation and the previous operation was 28 months. All patients were symptomatic. The surgical approach was a thoracotomy in 83 patients, laparotomy in 36, laparoscopy in 4, and thoracoabdominal in 1. A Nissen fundoplication was performed in 86 patients (69.4%), Belsey fundoplication in 31(25.0%), and others in 7. Results: There were no operative deaths. Complications occurred in 27 patients (21.7%). Median hospitalization was 6 days (range, 5 to 58 days). Follow-up ranged from 10 days to 10 years (median, 9.7 months). Improvement was observed in 114 patients (91.9%). Functional results were classified as excellent in 69 patients (55.6%), good in 19 (15.4%), fair in 26 (20.9%), and poor in 10 (8.1%). No single operative approach was functionally superior. Conclusions: We conclude that reoperation for failed antireflux surgery is safe and effective. Results of reoperation were not affected by the type of reoperation or whether the previous approach was laparoscopic or open.

Original languageEnglish (US)
Pages (from-to)2050-2054
Number of pages5
JournalAnnals of Thoracic Surgery
Volume81
Issue number6
DOIs
StatePublished - Jun 2006

Fingerprint

Reoperation
Fundoplication
Laparoscopy
Hiatal Hernia
Thoracotomy
Gastroesophageal Reflux
Laparotomy
Hospitalization

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ohnmacht, G. A., Deschamps, C., Cassivi, S. D., Nichols, F. C., Allen, M. S., Schleck, C. D., & Pairolero, P. C. (2006). Failed Antireflux Surgery: Results After Reoperation. Annals of Thoracic Surgery, 81(6), 2050-2054. https://doi.org/10.1016/j.athoracsur.2006.01.019

Failed Antireflux Surgery : Results After Reoperation. / Ohnmacht, Galen A.; Deschamps, Claude; Cassivi, Stephen D.; Nichols, Francis C.; Allen, Mark S.; Schleck, Cathy D.; Pairolero, Peter C.

In: Annals of Thoracic Surgery, Vol. 81, No. 6, 06.2006, p. 2050-2054.

Research output: Contribution to journalArticle

Ohnmacht, GA, Deschamps, C, Cassivi, SD, Nichols, FC, Allen, MS, Schleck, CD & Pairolero, PC 2006, 'Failed Antireflux Surgery: Results After Reoperation', Annals of Thoracic Surgery, vol. 81, no. 6, pp. 2050-2054. https://doi.org/10.1016/j.athoracsur.2006.01.019
Ohnmacht GA, Deschamps C, Cassivi SD, Nichols FC, Allen MS, Schleck CD et al. Failed Antireflux Surgery: Results After Reoperation. Annals of Thoracic Surgery. 2006 Jun;81(6):2050-2054. https://doi.org/10.1016/j.athoracsur.2006.01.019
Ohnmacht, Galen A. ; Deschamps, Claude ; Cassivi, Stephen D. ; Nichols, Francis C. ; Allen, Mark S. ; Schleck, Cathy D. ; Pairolero, Peter C. / Failed Antireflux Surgery : Results After Reoperation. In: Annals of Thoracic Surgery. 2006 ; Vol. 81, No. 6. pp. 2050-2054.
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abstract = "Background: Since laparoscopy has become a common surgical approach for antireflux surgery, little is known regarding reoperation for failed antireflux surgery. Methods: Records of all patients who underwent reoperation without esophageal resection for symptoms of recurrent gastroesophageal reflux disease or hiatal hernia between July 1, 1995 and April 1, 2004 were reviewed. There were 126 patients. Two patients declined research participation. The remaining 124 patients (71 women and 53 men) formed the basis for this study. Median age was 53 years (range, 19 to 83 years). The initial operation was a laparoscopic antireflux procedure in 76 patients (61.3{\%}) and an open repair in 48 (38.7{\%}). A single previous operation had been done in 100 patients, two operations in 20, and three operations in 4. The median interval between the most recent reoperation and the previous operation was 28 months. All patients were symptomatic. The surgical approach was a thoracotomy in 83 patients, laparotomy in 36, laparoscopy in 4, and thoracoabdominal in 1. A Nissen fundoplication was performed in 86 patients (69.4{\%}), Belsey fundoplication in 31(25.0{\%}), and others in 7. Results: There were no operative deaths. Complications occurred in 27 patients (21.7{\%}). Median hospitalization was 6 days (range, 5 to 58 days). Follow-up ranged from 10 days to 10 years (median, 9.7 months). Improvement was observed in 114 patients (91.9{\%}). Functional results were classified as excellent in 69 patients (55.6{\%}), good in 19 (15.4{\%}), fair in 26 (20.9{\%}), and poor in 10 (8.1{\%}). No single operative approach was functionally superior. Conclusions: We conclude that reoperation for failed antireflux surgery is safe and effective. Results of reoperation were not affected by the type of reoperation or whether the previous approach was laparoscopic or open.",
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