[Recurrence of gastroesophageal reflux: role of the abdominal approach and the restoration of the antireflux device].
One to five percent of patients who have undergone antireflux operation will be reoperated on for severe persistent or recurrent symptoms. Most cases of failed operation are observed after Nissen fundoplication: partially or totally disrupted fundic wrap, slipping of the fundoplication, perigastric wrapping, gastric para-esophageal hernia. Preoperative functional tests, including manometry, can identify the factors responsible for failure of the initial operation and guide the choice for remedial surgery. A review of the literature shows that the results at reoperation are not as good as those at the primary procedure: mortality is 0 to 12%, morbidity 7 to 57%, good functional results 75 to 96%.


CONCLUSIONS
remedial surgery is possible through a transabdominal approach at the first operation. Redo-fundoplication is recommended. Nissen or Collis-Nissen procedure is the most frequently performed. Results are directly related to the number of previous operations.
Triboulet
J P
JP
Clinique Chirurgicale Adultes Est, Cité Hospitalière, Lille.
Courtade
A
A
Carnaille
B
B
Proye
C
C
D000005:Abdomen; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D017211:Treatment Failure
Récidive du reflux gastro-oesophagien: place de la voie d'abord abdominale et de la réfection du dispositif anti-reflux.