title: Post-fundoplication symptoms and complications: Diagnostic approach and treatment.
abstract: Laparoscopic Nissen fundoplication is currently considered the surgical treatment of choice for gastroesophageal reflux disease (GERD) and its long-term effectiveness is above 90%. Adequate patient selection and the experience of the surgeon are among the predictive factors of good clinical response. However, there can be new, persistent, and recurrent symptoms after the antireflux procedure in up to 30% of the cases. There are numerous causes, but in general, they are due to one or more anatomic abnormalities and esophageal and gastric function alterations. When there are persistent symptoms after the surgical procedure, the surgery should be described as "failed". In the case of a patient that initially manifests symptom control, but the symptoms then reappear, the term "dysfunction" could be used. When symptoms worsen, or when symptoms or clinical situations appear that did not exist before the surgery, this should be considered a "complication". Postoperative dysphagia and dyspeptic symptoms are very frequent and require an integrated approach to determine the best possible treatment. This review details the pathophysiologic aspects, diagnostic approach, and treatment of the symptoms and complications after fundoplication for the management of GERD.
authors.affiliation: Servicio de Endoscopia, Hospital Ángeles del Pedregal, Ciudad de México, México. Electronic address: ssobrinocossio@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Sobrino-Cossío
authors.affiliation: Clínica de Fisiología Digestiva (Motilab), Clínica Medivalle, Ciudad de México, México; Clínica de Fisiología Digestiva, Hospital Ángeles Metropolitano, Ciudad de México, México; Servicio de Endoscopia, Hospital Central Sur de Alta Especialidad PEMEX, Ciudad de México, México.
authors.forename: J C
authors.initials: JC
authors.lastname: Soto-Pérez
authors.affiliation: Laboratorio de Motilidad y Fisiología Digestiva, Instituto Nacional de Ciencias Médicas y de la Nutrición «Dr. Salvador Zubirán», Ciudad de México, México.
authors.forename: E
authors.initials: E
authors.lastname: Coss-Adame
authors.affiliation: Servicio de Endoscopia, Hospital Ángeles del Pedregal, Ciudad de México, México.
authors.forename: G
authors.initials: G
authors.lastname: Mateos-Pérez
authors.affiliation: Laboratorio de Motilidad, Hospital Ángeles de Interlomas, Huixquilucan, México.
authors.forename: O
authors.initials: O
authors.lastname: Teramoto Matsubara
authors.affiliation: Departamento de Trastornos Funcionales Digestivos, Gedyt-Gastroenterología Diagnóstica y Terapéutica, Buenos Aires, Argentina.
authors.forename: J
authors.initials: J
authors.lastname: Tawil
authors.affiliation: Servicio de Cirugía General, Hospital Ángeles de Querétaro, Querétaro, México.
authors.forename: M
authors.initials: M
authors.lastname: Vallejo-Soto
authors.affiliation: Servicio de Cirugía General, Hospital Central Militar, Ciudad de México, México.
authors.forename: A
authors.initials: A
authors.lastname: Sáez-Ríos
authors.affiliation: Cirugía general, práctica privada, Ciudad de México, México.
authors.forename: J A
authors.initials: JA
authors.lastname: Vargas-Romero
authors.affiliation: Unidad de Endoscopia, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, México.
authors.forename: A M
authors.initials: AM
authors.lastname: Zárate-Guzmán
authors.affiliation: Unidad de Gastroenterología, Hospital Privado, Guadalajara, Jalisco, México.
authors.forename: E S
authors.initials: ES
authors.lastname: Galvis-García
authors.affiliation: Unidad de Radiología, Hospital Ángeles del Pedregal, Ciudad de México, México.
authors.forename: M
authors.initials: M
authors.lastname: Morales-Arámbula
authors.affiliation: Servicio de Cirugía General, Hospital Ángeles del Pedregal, Ciudad de México, México.
authors.forename: O
authors.initials: O
authors.lastname: Quiroz-Castro
authors.affiliation: Laboratorio de Motilidad y Fisiología Digestiva, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: A
authors.initials: A
authors.lastname: Carrasco-Rojas
authors.affiliation: Laboratorio de Motilidad y Fisiología Digestiva, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: J M
authors.initials: JM
authors.lastname: Remes-Troche
mesh_terms: D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D016896:Treatment Outcome
keywords: Disfagia; Dysphagia; Enfermedad por reflujo gastroesofágico; Fundoplication; Funduplicatura; Gastroesophageal reflux disease; Heartburn; Pirosis