title: Reoperative antireflux surgery.
abstract: Patient satisfaction with primary antireflux surgery is high, but a small percentage of patients experience recurrent reflux and dysphagia, requiring reoperation. The major anatomic causes of failed fundoplication are slipped fundoplication, failure to identify a short esophagus, and problems with the wrap. Minimally invasive surgery has become more common for these procedures. Options for surgery include redo fundoplication with hiatal hernia repair if needed, conversion to Roux-en-Y anatomy, or, as a last resort, esophagectomy. Conversion to Roux-en-Y anatomy has a high rate of success, making this approach an important option in the properly selected patient.
authors.affiliation: Department of General and Vascular Surgery, Gundersen Health System, 1900 South Avenue, C05-001, La Crosse, WI 54601, USA.
authors.forename: Brandon T
authors.initials: BT
authors.lastname: Grover
authors.affiliation: Department of General and Vascular Surgery, Gundersen Health System, 1900 South Avenue, C05-001, La Crosse, WI 54601, USA. Electronic address: snkothar@gundersenhealth.org.
authors.forename: Shanu N
authors.initials: SN
authors.lastname: Kothari
mesh_terms: D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods*; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D011300:Preoperative Care; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D017211:Treatment Failure
keywords: Collis gastroplasty; Gastroesophageal reflux disease; Nissen fundoplication; Outcomes; Preoperative evaluation; Revisional surgery; Roux-en-Y gastric bypass