Herniation of an abdominal antireflux fundoplication into the chest: what does it mean?

• Published in: European journal of cardio-thoracic surgery 2014-07, Vol.46 (1), p.121-126
• Main Authors: Deswysen, Yannick, Volonté, Francesco, Gutschow, Christian, Romagnoli, Renato, Strignano, Paolo, Ouazzani, Aous, Verstraete, Luc, De Gheldere, Charles, Thoma, Maximillien, Uluma, Vincent, Ungureanu, Felicia, Mabrut, Jean-Yves, Collard, Jean-Marie
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Chest Pain - etiology; Deglutition Disorders - etiology; Esophagus - surgery; Female; Fundoplication - adverse effects; Fundoplication - methods; Gastroesophageal Reflux - surgery; Hernia, Abdominal - etiology; Hernia, Abdominal - surgery; Hernia, Hiatal - etiology; Hernia, Hiatal - surgery; Humans; Male; Middle Aged; Necrosis; Pressure; Reoperation; Retrospective Studies; Risk Factors; Treatment Failure; Young Adult
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezt553

OBJECTIVES The specific contribution of the herniation of an abdominal antireflux fundoplication into the chest to symptomatic and therefore surgical failure remains unclear. METHODS The study was conducted in 189 consecutive fundoplication patients, categorized as patients reoperated on for chest herniation of either an abdominal 360° (Group 1; n = 95) or a partial (Group 2; n = 10) fundoplication, and patients having undergone an intrathoracic 360° fundoplication for short oesophagus (Group 3; n = 84; reference group). There were four subgroups in Group 1: 1A: wrap still complete and perioesophageal; 1B: wrap still complete but perigastric; 1C: wrap still perioesophageal but partially disrupted and 1D: wrap perigastric and partially disrupted. RESULTS The prevalence of defective symptoms (heartburn and regurgitation) was significantly lower (P