Primary and Redo Antireflux Surgery: Outcomes and Lessons Learned

• Published in: Journal of gastrointestinal surgery 2018-02, Vol.22 (2), p.177-186
• Main Authors: Singhal, Saurabh, Kirkpatrick, Daniel R., Masuda, Takahiro, Gerhardt, Janese, Mittal, Sumeet K.
• Format: Article
• Language: English
• Subjects: 2017 SSAT Plenary Presentation; Adult; Aged; Anastomosis, Roux-en-Y - adverse effects; Blood Loss, Surgical; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Female; Fundoplication - adverse effects; Gastroenterology; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - surgery; Gastrointestinal surgery; Heartburn - etiology; Heartburn - surgery; Humans; Laparoscopy - adverse effects; Male; Medicine; Medicine & Public Health; Middle Aged; Operative Time; Patient Satisfaction; Postoperative Complications - etiology; Recurrence; Reoperation - adverse effects; Retrospective Studies; Surgery; Surveys and Questionnaires; Symptom Assessment; Treatment Outcome
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-017-3480-4

Introduction Some patients require one or more reoperative interventions after undergoing primary antireflux surgery (ARS). We compared outcomes after primary and reoperative ARS. Methods We queried a prospectively maintained database to identify patients who underwent ARS from September 23, 2003 to May 28, 2016. Patients were categorized into four groups: A (primary ARS), B (first reoperative ARS), C (second reoperative ARS), or D (≥ third reoperative ARS). Patients completed follow-up foregut symptom surveys and satisfaction questionnaires at regular intervals. Results In total, 940 patients were studied (A: n  = 545, B: n  = 302, C: n  = 80, D: n  = 13). Age, sex, and BMI were comparable across groups. Heartburn was the most common preoperative symptom in A, whereas dysphagia was more common in B–D. Open approach, mean operative time, and mean blood loss increased from A to D ( P