Laparoscopic reoperative antireflux surgery: A safe procedure with high patient satisfaction and low morbidity.
BACKGROUND
Laparoscopic reoperative antireflux surgery remains challenging and the advantages compared to an open approach remain unclear.


METHODS
Retrospective chart review and follow-up questionnaire via phone.


RESULTS
50 reoperative hiatal hernia repairs were performed in 47 patients.


METHODS
median and interquartile range (IQR). There were 10 males, 37 females, 55 (49-66) years. Reoperative procedures: 38 laparoscopic vs. 12 open transabdominal. Length of operation: 185 (147-254) vs. 325 (276-394) minutes (p < 0.0008). Length of stay: 3 (2-4) vs.10 (8-13) days (p < 0.0001). None required Collis gastroplasty. There was no 30-day mortality. Follow-up questionnaire was obtained in 36/45 (80%) at 21 (11-40) months (2 cancer related deaths). In all, 24/36 (67%) were free of preoperative symptoms and 33/36 (92%) were satisfied with the operation. There was no difference between the laparoscopic and open group.


CONCLUSIONS
Laparoscopic reoperative antireflux surgery is a safe approach with high patient satisfaction and low morbidity. Tension-free esophageal length can be achieved laparoscopically without Collis gastroplasty. The duration of the operation and length of stay are less in the laparoscopic vs. open group. Symptomatic relief and patient satisfaction are similar in both approaches.
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), TX, USA; Memorial Hermann Southeast Esophageal Disease Center, Houston, TX, USA. Electronic address: Farzaneh.Banki@uth.tmc.edu.
Farzaneh
F
Banki
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), TX, USA.
Chandni
C
Kaushik
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), TX, USA.
David
D
Roife
Memorial Hermann Southeast Esophageal Disease Center, Houston, TX, USA.
Munish
M
Chawla
Memorial Hermann Southeast Esophageal Disease Center, Houston, TX, USA.
Robert
R
Casimir
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), TX, USA.
Charles C
CC
Miller
D000368:Aged; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
Laparoscopic approach; Recurrent hiatal hernia; Reoperative antireflux surgery