title: [Complications and reoperations following laparoscopic antireflux surgery].
abstract: Laparoscopic antireflux surgery is an effective treatment for patients with gastro-esophageal reflux disease, when it is refractory to conservative management. In experienced centers the procedure is safe, although complications may develop either during surgery or in the early or late postoperative period, which may necessitate revisional surgery. Between 1998 and 2015 a total of 407 patients underwent laparoscopic antireflux surgery at the Department of Surgery, University of Pécs. This interval was divided into two periods. In the first one, between 1998 and 2006, we operated on 241 patients who were all enrolled in a prospective study. All the diagnostic examinations were carried out at our institution. In the second period 166 patients were treated with minimal invasive surgery and the data were analyzed retrospectively. The 407 patients comprised 161 men and 246 women with a median age of 53,1 years. Hiatoplasty was reinforced with teres ligament in 27 cases, a prosthetic mesh was used in 28 cases and fascia lata in a four cases, when hiatal closures were not considered reliable. In 16 cases (4%) the operation was converted to open procedure, and our mortality rate was 0,5%. Revisional surgery was performed laparoscopically in 39 patients, and thoraco-laparotomy was done in six cases (12%). 5 additional reoperations were performed in patients, who had their primary antireflux surgery in another institution. Our 4% conversion, 12% reoperation and 0,5% mortality rates correspond to the figures published in the literature. In conclusion, this study confirms that laparoscopic antireflux surgery is a safe procedure with very good clinical outcomes. Late complications, such as recurrent reflux disease and reherniation, as well as revisional surgery occured almost exclusively after surgical treatment of the large hiatal hernias.
authors.affiliation: Klinikai Központ, Sebészeti Klinika, Pécsi Tudományegyetem 7624 Pécs, Ifjúság út 13.
authors.forename: Örs Péter
authors.initials: ÖP
authors.lastname: Horváth
authors.affiliation: Klinik für Allgemein-,Viszeral- und Thoraxchirurgie, AGAPLESION Markus Krankenhaus Frankfurt am Main.
authors.forename: Gábor
authors.initials: G
authors.lastname: Varga
authors.affiliation: Klinikai Központ, Sebészeti Klinika, Pécsi Tudományegyetem 7624 Pécs, Ifjúság út 13.
authors.forename: Zsanett
authors.initials: Z
authors.lastname: Biró
authors.affiliation: Klinikai Központ, Sebészeti Klinika, Pécsi Tudományegyetem 7624 Pécs, Ifjúság út 13.
authors.forename: András
authors.initials: A
authors.lastname: Papp
authors.affiliation: Sebészeti Oktató- és Kutatóintézet, Pécsi Tudományegyetem Pécs.
authors.forename: Laura
authors.initials: L
authors.lastname: Bognár
authors.affiliation: Klinikai Központ, Sebészeti Klinika, Pécsi Tudományegyetem 7624 Pécs, Ifjúság út 13.
authors.forename: András
authors.initials: A
authors.lastname: Vereczkei
mesh_terms: D000328:Adult; D000368:Aged; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006551:Hernia, Hiatal / Q000209:etiology / Q000601:surgery; D006801:Humans; D006814:Hungary; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013526:Surgical Mesh; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: antireflux surgery; antirefluxműtét; complications; gastro-esophageal reflux disease; gastrooesophagealis reflux; large hiatal hernia; nagy hiatushernia; reoperation; reoperációk; szövődmények