The management of patients who have "failed" antireflux surgery.
Gastroenterologists may be called upon to manage patients who have had antireflux surgery that failed. The available literature on this topic comprises predominantly reports on retrospective, observational studies written by surgeons who often have focused on how technical deficiencies in performing the operation led to the failure. Such reports are of limited value to the gastroenterologist seeking guidance on patient management. Furthermore, comparisons among the reports are confounded by the lack of a standardized definition for failed antireflux surgery. This report critically reviews the available literature, and suggests a practical approach to the management of patients who have symptoms that were not completely relieved, that reappeared later, or that were caused by antireflux surgery.
Spechler
Stuart Jon
SJ
Dallas Department of Veterans Affairs Medical Center and The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75216, USA.
D003680:Deglutition Disorders / Q000209:etiology; D004945:Esophagoscopy; D004947:Esophagus / Q000378:metabolism; D018662:Fundoplication / Q000009:adverse effects; D005740:Gases; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D012008:Recurrence; D013270:Stomach; D017211:Treatment Failure
D005740:Gases