Third-time ("redo-redo") anti-reflux surgery: patient-reported outcomes after a thoracoabdominal approach.

Surgical Endoscopy
Nikhil PandaChristopher R Morse

Abstract

Approximately 3-6% of patients undergoing anti-reflux surgery require "redo" surgery for persistent gastroesophageal reflux disease (GERD). Further surgery for patients with two failed prior anti-reflux operations is controversial due to the morbidity of reoperation and poor outcomes. We examined our experience with surgical revision of patients with at least two failed anti-reflux operations. Adults undergoing at least a second-time revision anti-reflux surgery between 1999 and 2017 were eligible. The primary outcomes were general and disease-specific quality-of-life (QoL) scores determined by Short-Form-36 (SF36) and GERD-Health-Related QoL (GERD-HRQL) instruments, respectively. Secondary outcomes included perioperative morbidity and mortality. Eighteen patients undergoing redo-redo surgery (13 with 2 prior operations, 5 with 3 prior operations) were followed for a median of 6 years [IQR 3, 12]. Sixteen patients (89%) underwent open revisions (14 thoracoabdominal, 2 laparotomy) and two patients had laparoscopic revisions. Indications for surgery included reflux (10 patients), regurgitation (5 patients), and dysphagia (3 patients). Intraoperative findings were mediastinal wrap herniation (9 patients), misplaced wrap (2 patient...Continue Reading

References

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Citations

Jan 21, 2021·Asian Journal of Endoscopic Surgery·Fumiaki YanoToru Ikegami
Jun 29, 2021·Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches·Nikhil PandaAlex B Haynes
Jul 21, 2021·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Lisa van den BergChristopher J Sidey-Gibbons

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