Strategies for Surgical Remediation of the Multi-Fundoplication Failure Patient

Antiporda, Michael; Jackson, Chloe; Smith, Calvin; Thomas, Mathew; Elli, Enrique F.; Bowers, Steven P.

doi:10.1016/s0016-5085(17)34061-1

Cited by 2 publications

(3 citation statements)

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“…Dado que el grado de satisfacción posterior a cada reintervención es menor en comparación con la primera cirugía, reportándose en hasta 81%, 13,14 no es raro encontrar casos con tres o más procedimientos que persisten sintomáticos, por lo que el tipo de reparación se convierte en el punto cardinal determinante de la posibilidad de recidiva. Al día de hoy, no existe un número particular de intervenciones de la unión esófago-gástrica a partir del cual una cirugía más esté contraindicada.…”

Section: Resultsunclassified

“…Al día de hoy, no existe un número particular de intervenciones de la unión esófago-gástrica a partir del cual una cirugía más esté contraindicada. 14 Técnicas derivativas como la Y de Roux o Billroth II cobran especial importancia en aquéllos con múltiples factores de riesgo como obesidad mórbida, dismotilidad esofágica, esófago corto, disfagia severa o más de una reintervención. 4,13 La comparación sistemática entre la primera cirugía antirreflujo y cada procedimiento subsecuente ha sido reportada en pocos estudios en la era laparoscópica, 4 por lo que consideramos el presente trabajo como un contribuyente más al estudio de los resultados de múltiples intervenciones quirúrgicas en el tratamiento de ERGE recidivante o persistente.…”

Section: Resultsunclassified

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ERGE persistente o recidivante luego de cirugía antirreflujo, síntomas que llevan a la reintervención en un hospital privado de la Ciudad de México

Ruiz¹,

Anzures²,

Romo³

2022

Acta Médica Grupo Ángeles

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The persistence or recurrence of symptoms after antireflux surgery is associated with poor study and initial approach, failures in surgical technique and risk factors specific to the patient. In order to describe the symptoms that lead to a new intervention, time since the first procedure, the technique used and the characteristics of the patients, a retrospective systematic review of 100 clinical records of cases undergoing reintervention of antirreflux surgery during the last four years was carried out in Angeles Pedregal Hospital in Mexico City. Cases with up to three previous surgeries were found, the results showed that heartburn (65%), regurgitation (58%) and epigastric pain (28%) were the most frequent symptoms. The most important isolated risk factor was obesity (23%). More than 50% underwent reoperation within the first 10 years, with slippage of the fundoplication being the most common failure mechanism (71%). Although the results largely coincide with the literature, the systematic comparison of cases with two or more surgeries as in our sample has been reported in few studies in the laparoscopic era, so the present work contributes to the analysis of cases with multiple anti-reflux surgical treatments.

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Section: Resultsunclassified

ERGE persistente o recidivante luego de cirugía antirreflujo, síntomas que llevan a la reintervención en un hospital privado de la Ciudad de México

Ruiz¹,

Anzures²,

Romo³

2022

Acta Médica Grupo Ángeles

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“…To date, many studies have suggested that despite revisional RYGB having a somewhat higher complication rate than revisional fundoplication, it is generally safe and at least as effective as revisional fundoplication in controlling the symptoms of GERD in the short term. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] However, there have been fewer studies assessing the long-term outcomes of patients who undergo RYGB after fundoplication, particularly with regard to the change in the proton pump inhibitor (PPI) use and resolution of obesity-related comorbidities. In this descriptive study, we assess the long-term safety and efficacy of RYGB after failed fundoplication in terms of the complication rate, change in PPI usage, weight loss, and resolution of obesity-related comorbidities.…”

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Efficacy and Safety of Recurrent Paraesophageal Hernia Repair with Roux-en-Y Gastric Bypass

Spann

Harrison

English

et al. 2020

The American Surgeon

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Roux-en-Y gastric bypass (RYGB) has been explored as a revisional option to failed paraesophageal hernia (PEH) repair with fundoplication, particularly in patients suffering from obesity. However, few studies have assessed long-term outcomes of RYGB with revisional PEH repairin regard to acid-suppressing medication use. We retrospectively identified 19 patients who underwent revisional PEH repair with RYGB between 2011 and 2018. The median operative time was 232 minutes with a median hospital length of stay of two days. The median length of follow-up was 24 months. Two patients (10.5%) had complications in the first 30 days, and five patients (26.3%) had complications within one year. Of the 12 patients on preoperative acid suppression, 6 (50%) were either off medication or on reduced dose at 12 months. The median BMI decrease was 14.4 kg/m2 at 12 months and did not change significantly afterward. Although rates of acid-suppression medication use did not change overall after revisional PEH repair with RYGB, patients experienced successful long-term management of morbid obesity and sustained weight loss. Revisional PEH repair with RYGB is a safe and effective option, with a complication rate comparable with the reported rates after revisional foregut procedures such as revisional Nissen fundoplication.

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Strategies for Surgical Remediation of the Multi-Fundoplication Failure Patient

Cited by 2 publications

References 0 publications

ERGE persistente o recidivante luego de cirugía antirreflujo, síntomas que llevan a la reintervención en un hospital privado de la Ciudad de México

ERGE persistente o recidivante luego de cirugía antirreflujo, síntomas que llevan a la reintervención en un hospital privado de la Ciudad de México

Efficacy and Safety of Recurrent Paraesophageal Hernia Repair with Roux-en-Y Gastric Bypass

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