Complications after anti-reflux surgery.
Anti-reflux operations are frequently performed in a variety of different hospital categories. Surgical repair of the reflux-preventing mechanisms is very effective in preventing a relapse of the reflux, but the side effects of surgery sometimes mar an otherwise excellent postsurgical result. The side effects of anti-reflux surgery are mainly due to an overcorrection of the anti-reflux mechanisms in the gastro-oesophageal junction area. A restrained passage of swallowed food through the gastro-oesophageal junction is a fairly regular phenomenon postoperatively, although it causes astonishingly few symptoms except during the early postoperative period. No patient should be able to vomit after a well-functioning anti-reflux procedure, although the ability to belch is usually reported to be maintained despite objective evidence to suggest significant deficiencies, which may cause bloating and rectal flatulence. A variety of factors have been suggested to counteract some of the side effects of anti-reflux surgery. The best-documented preventive strategy presented so far is to carry out a posterior partial fundoplication and to ensure that the patient is operated on in a high-volume, specialised centre.
Lundell
L
L
Division of Surgery, Karolinska University Hospital, Huddinge, S-141 86 Stockholm, Sweden. lars.lundell@hs.se
D003680:Deglutition Disorders / Q000209:etiology; D004947:Esophagus / Q000293:injuries; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D012008:Recurrence; D012086:Reoperation; D013154:Spleen / Q000293:injuries