Indications and Options for Esophago-Gastric Junction Resection and Reconstruction in Failed Anti-Reflux Surgery

Abstract

Revisional anti-reflux surgery is complex. The most common revisional procedure following anti-reflux surgery is redo-fundoplication; however, there is a rate of diminishing return for each subsequent redo-fundoplication. In addition, postoperative complications involving the gastroesophageal junction or intraoperative complications may require resection of the gastroesophageal junction and reconstruction. There is limited data evaluating the options for patients undergoing resectional surgery following ARS, but this paper will review the current literature and provide an overview on the indications and reconstructive options following gastro-esophageal junction resection.

Preface to Revisional Antireflux Surgery

“…The authors discuss basic issues such as endoscopic assessment of postfundoplication anatomy (Dr. Ayazi) 1 as well as gastrointestinal (Dr. Chandra) 2 and surgical (Dr. Kroh) 3 perspectives of patient symptoms and evaluation. Extensive reviews on the transthoracic approach (Dr. Bremner), 4 Roux-en-Y reconstruction (Dr. Awais), 5 gastroparesis (Dr. Black), 6 esopahgogastric resection (Dr. Wisniowski), 7 and outcomes after reoperative intervention (Dr. Xu) 8 follow. We round off this edition with a section on technical aspects of reoperative procedures (Dr. Khaitan).…”