title: Laparoscopic revision of failed antireflux surgery: a systematic review.
abstract: BACKGROUND
  Laparoscopic antireflux surgery is an accepted treatment for persistent gastroesophageal reflux but about 4% of patients will eventually require revision surgery.
  
  
  METHODS
  We searched The Cochrane Collaboration, Medline, and EMBASE databases, augmented by Google Scholar and PubMed related articles from January 1, 1990, to November 22, 2010. Twenty studies met the inclusion criteria, reporting on 930 surgeries.
  
  
  RESULTS
  The mean surgical duration was 166 minutes and conversion to open revision fundoplication was required in 7% of cases. Complications were reported in 14% of cases and the mean length of stay varied between 1.2 and 6 days. A good to excellent result was reported for 84% of surgeries and 5% of patients required a further revisional procedure.
  
  
  CONCLUSIONS
  Laparoscopic revision antireflux surgery appears to be feasible and safe, but subject to somewhat greater risk of conversion, higher morbidity, longer hospital stay, and poorer outcomes than primary laparoscopic fundoplication.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Academic Surgical Unit, 10th Floor, QEQM Building, South Wharf Rd., London, W2 1NY UK.
authors.forename: Nicholas R A
authors.initials: NR
authors.lastname: Symons
authors.forename: Sanjay
authors.initials: S
authors.lastname: Purkayastha
authors.forename: Bruno
authors.initials: B
authors.lastname: Dillemans
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.forename: George B
authors.initials: GB
authors.lastname: Hanna
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Zacharakis
mesh_terms: D005240:Feasibility Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D009017:Morbidity; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D017211:Treatment Failure; D016896:Treatment Outcome