Outcome following management of dysphagia after laparoscopic anti-reflux surgery.
BACKGROUND
Some patients develop troublesome dysphagia after laparoscopic antireflux surgery, and a proportion require further intervention. The management of this problem was evaluated.


METHODS
Patients who underwent intervention for dysphagia after laparoscopic fundoplication were identified from a database. Outcomes were prospectively determined from a standardized questionnaire that evaluated symptoms scores for dysphagia for solids and liquids, as well as patient satisfaction with the overall outcome. Outcomes 1 year after reintervention, and at the most recent follow-up were evaluated.


RESULTS
From 1994 to 2009, 121 (6.6%) of 1,821 patients who underwent laparoscopic fundoplication for gastroesophageal reflux also underwent endoscopic or surgical reintervention for dysphagia. Of these 121 patients, 56 underwent endoscopic dilatation, and 24 were satisfied with the outcome of dilatation; 18 progressed to surgery, and dysphagia persisted in 14 of them. Overall, 83 patients underwent revisional surgery, and 47 (62.7%) were satisfied with the outcome. Compared to patients who did not undergo any intervention for dysphagia, patients who underwent reintervention had lower satisfaction scores and higher dysphagia scores.


CONCLUSIONS
Approximately two thirds of patients with troublesome post-fundoplication dysphagia have a satisfactory outcome following either endoscopic dilatation or revisional surgery. However, approximately one third continue to be troubled by symptoms, despite further intervention.
Flinders University Department of Surgery, Room 3D211, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
Huiqi
H
Yang
Cindy
C
Meun
Xiangyu
X
Sun
David I
DI
Watson
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004106:Dilatation; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012086:Reoperation; D016896:Treatment Outcome