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

43 Scopus citations

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 1 2006

ASJC Scopus subject areas

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

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    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