2019
DOI: 10.1590/0102-672020190001e1440
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Failure After Fundoplication: Re-Fundoplication? Is There a Room for Gastrectomy? In Which Clinical Scenaries?

Abstract: Background: Re-fundoplication is the most often procedure performed after failed fundoplication, but re-failure is even higher. Aim: The objectives are: a) to discuss the results of fundoplication and re-fundoplication in these cases, and b) to analyze in which clinical situation there is a room for gastrectomy after failed fundoplication. Method: This experience includes 104 patients submitted to re-fundoplication after failure of the initial operation, 50 cases of long segment Barrett´s esophagus and 60 pa… Show more

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Cited by 13 publications
(9 citation statements)
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“…Partial or total fundoplication in a systematic or selective manner is also questionable, and it can be applied only to patients with previous reflux symptoms or in all cases . 17 , 18 In this study, fundoplication was performed in 94.12% of cases (preferably using the Nissen technique – 52.94%) considering that the extensive esophageal dissection close to the hiatus, the division of the posterior phrenoesophageal ligament and the break of the esophageal continence mechanism by the large existing hiatal hernia, could result in gastroesophageal reflux. In addition, fundoplication would reduce the mobility of the gastric fundus, reducing the risk of herniation to the chest cavity recurrence.…”
Section: Discussionmentioning
confidence: 99%
“…Partial or total fundoplication in a systematic or selective manner is also questionable, and it can be applied only to patients with previous reflux symptoms or in all cases . 17 , 18 In this study, fundoplication was performed in 94.12% of cases (preferably using the Nissen technique – 52.94%) considering that the extensive esophageal dissection close to the hiatus, the division of the posterior phrenoesophageal ligament and the break of the esophageal continence mechanism by the large existing hiatal hernia, could result in gastroesophageal reflux. In addition, fundoplication would reduce the mobility of the gastric fundus, reducing the risk of herniation to the chest cavity recurrence.…”
Section: Discussionmentioning
confidence: 99%
“…Healing rates were compared among groups. The χ 2 test and t-test were used, respectively, for enumeration and measurement data.\\n\\nRESULTS: There were 176 H. pylori positive (with 92 eradication cases studied 846 patients with reflux esophagitis who underwent treatment with pantoprazole (40 mg). After four weeks of treatment the reflux esophagitis healing rate was 86.6% in patients with HP positive.…”
Section: Discussionmentioning
confidence: 99%
“…The relationship between HP and diseases related to esophageal acid reflux is uncertain 2 , 23 . It is currently advocated that the presence of this bacterium in the gastric mucosa may trigger a protective effect for patients with gastroesophageal reflux disease (GERD), both for esophagitis and for the development of EB and esophageal adenocarcinoma.…”
Section: Introductionmentioning
confidence: 99%
“…Concurrent with the increase number of LFP over the last two decades 8,14,16,21 the number of dissatisfied patients, presenting relapses or new symptoms after surgery has also arrised 2 , 11 , 16 , 21 . Given this scenario, precise endoscopic evaluation of valve fundoplication is extremely important because it allows the medical team to recognize abnormalities and to establish treatment strategies, especially if surgical reintervention is being considered 21 , 25 .…”
Section: Introductionmentioning
confidence: 99%