Complications of antireflux surgery.
In order to determine the in-hospital morbidity and mortality rates of antireflux surgery in a community hospital setting, a retrospective 10-year review of 355 antireflux procedures was conducted. A modified Nissen fundoplication, with an incomplete fundal wrap, was the most common operation performed. Concomitant procedures, usually biliary or gastric, were undertaken in 93 patients. Thirty-nine patients had previously undergone an operation involving hiatal dissection. Overall morbidity was 17%, and mortality was 1% (three deaths). Patients with previous hiatal surgery had higher morbidity (44%, p < 0.0001) and mortality rates (3%, p < 0.21). Wound infection occurred in 5% of patients and wound dehiscence in 1%. Splenic repair or splenectomy for iatrogenic injury was required in 2%. Postoperative gastroesophageal leaks occurred in six patients (2%). Patients with previous hiatal surgery had a higher incidence of gastroesophageal leaks (8%, p < 0.002). Three of six patients had contained leaks that resolved with antibiotics, cessation of oral intake, and nutritional support. Two of three patients with noncontained leaks died despite surgical intervention.
Urschel
J D
JD
Department of Surgery, Misericordia Hospital, Edmonton, Alberta, Canada.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000416:Alberta / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology; D004935:Esophageal Diseases / Q000453:epidemiology; D004947:Esophagus / Q000601:surgery; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006551:Hernia, Hiatal / Q000601:surgery; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology