Is Reoperative Laparoscopic Fundoplication an Effective Treatment for Previously Failed Anti-Reflux Procedures?

Dolce JK, Ross SB, Luberice K, Bourdeau T, Patel K, Sucandy I and Rosemurgy AS*

Advent Health Tampa, Tampa, Florida, USA

^*Correspondance to: Rosemurgy AS 

 PDF  Full Text DOI: 10.25107/2474-1647.2686

Abstract

Introduction: Given the great number of fundoplications undertaken since the advent of minimally invasive surgery, the small percentage of failed fundoplications translates to a significant number of patients requiring additional care, including reoperative fundoplications. Herein, we report our experience with “redo” fundoplications for failed anti-reflux surgery. Materials and Methods: From 1992 to 2016, patients having undergone a reoperative fundoplication were prospectively followed. Patients scored their frequency/severity of reflux symptoms before and after reoperative fundoplication using a Likert scale (0= never/not bothersome, 10= always/very bothersome). Results: Two hundred and thirty six patients underwent reoperative fundoplication, with a median age of 58 years. The leading indication (46% of patients) for reoperative fundoplication was wrap failure. Frequency/severity of heartburn was rated 8/8 preoperatively and 0/0 after fundoplication, respectively. Patients’ symptoms entirely resolved in 34%, occurred less than once a month in 39%, and less than once per week in 16%. Of all patients, 77% were “very satisfied” or “satisfied” with their reoperative fundoplication and 87% would undergo the operation again knowing what they know now. Conclusion: For patients suffering from persistent, recurrent, or new symptoms and/or excessive acid reflux after their initial fundoplication, a reoperative fundoplication significantly decreases the frequency/severity of symptoms. These results strongly encourage reoperative fundoplication after failed anti-reflux surgery.

Keywords

Cite the article

Dolce JK, Ross SB, Luberice K, Bourdeau T, Patel K, Sucandy I, et al. Is Reoperative Laparoscopic Fundoplication an Effective Treatment for Previously Failed Anti-Reflux Procedures?. Clin Surg. 2019; 4: 2686..