Laparoscopic revision for failed anti-reflux surgery. Preliminary results.
OBJECTIVE
Surgical treatment of gastroesophageal reflux disease has become common practice. These operations are known to fail in about 10%, the need for re-intervention approximates 5%. Re-fundoplications are feasible laparoscopically but are technically demanding.


METHODS
For the present paper, we reviewed retrospectively the 10 patients that, in our practice, needed a re-intervention for failure of a prior fundoplication. The causes were: narrowed passage at wrap level (n=4), intra-thoracic wrap migration (n=3), wrap disruption (n=2) and gastric volvulus (n=1).


RESULTS
All 10 patients underwent a re-operation consisting of a confection of a new 360 degrees wrap. All interventions were completed laparoscopically and no major complication occurred. The results of these revised fundoplications were satisfying with complete resolution of reflux and/or dysphagia in all patients but one. This latter patient still needed anti-acid medication for an unexplained persistent reflux.


CONCLUSIONS
In our experience, laparoscopic correction of failed fundoplications is technically feasible and associated with low rate of complications and high success rate.
Bataille
D
D
Service de Chirurgie Digestive, Coelioscopique et Thoracique, CHU Brugmann, ULB, Brussels, Belgium.
Simoens
Ch
Ch
Mendes da Costa
P
P
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure