title: Gastroesophageal reflux disease treatment: side effects and complications of fundoplication.
abstract: Even skilled surgeons will have complications after antireflux surgery. Fortunately, the mortality is low (<1%) with laparoscopic surgery, immediate postoperative morbidity is uncommon (5%-20%), and conversion to an open operation is <2.5%. Common late postoperative complications include gas-bloat syndrome (up to 85%), dysphagia (10%-50%), diarrhea (18%-33%), and recurrent heartburn (10%-62%). Most of these complications improve during the 3-6 months after surgery. Dietary modifications, pharmacologic therapies, and esophageal dilation may be helpful. Failures after antireflux surgery usually occur within the first 2 years after the initial operation. They fall into 5 patterns: herniation of the fundoplication into the chest, slipped fundoplication, tight fundoplication, paraesophageal hernia, and malposition of the fundoplication. Reoperation rates range from 0%-15% and should be performed by experienced foregut surgeons.
authors.affiliation: Division of Digestive Diseases and Nutrition, Center for Esophageal and Swallowing Disorders, University of South Florida Morsani College of Medicine, Tampa, Florida 33612, USA. jrichte1@health.usf.edu
authors.forename: Joel E
authors.initials: JE
authors.lastname: Richter
mesh_terms: D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D004032:Diet / Q000379:methods; D004106:Dilatation; D018662:Fundoplication / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006356:Heartburn / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology* / Q000473:pathology*
chemical_list: D005765:Gastrointestinal Agents