Dolce JK, Ross SB, Luberice K, Bourdeau T, Patel K, Sucandy I and Rosemurgy AS*
Advent Health Tampa, Tampa, Florida, USAFulltext PDF
Introduction: Given the great number of fundoplications undertaken since the advent of minimally invasive surgery, the small percentage of failed fundoplications translates to a significant number of patients requiring additional care, including reoperative fundoplications. Herein, we report our experience with “redo” fundoplications for failed anti-reflux surgery. Materials and Methods: From 1992 to 2016, patients having undergone a reoperative fundoplication were prospectively followed. Patients scored their frequency/severity of reflux symptoms before and after reoperative fundoplication using a Likert scale (0= never/not bothersome, 10= always/very bothersome). Results: Two hundred and thirty six patients underwent reoperative fundoplication, with a median age of 58 years. The leading indication (46% of patients) for reoperative fundoplication was wrap failure. Frequency/severity of heartburn was rated 8/8 preoperatively and 0/0 after fundoplication, respectively. Patients’ symptoms entirely resolved in 34%, occurred less than once a month in 39%, and less than once per week in 16%. Of all patients, 77% were “very satisfied” or “satisfied” with their reoperative fundoplication and 87% would undergo the operation again knowing what they know now. Conclusion: For patients suffering from persistent, recurrent, or new symptoms and/or excessive acid reflux after their initial fundoplication, a reoperative fundoplication significantly decreases the frequency/severity of symptoms. These results strongly encourage reoperative fundoplication after failed anti-reflux surgery.
Dolce JK, Ross SB, Luberice K, Bourdeau T, Patel K, Sucandy I, et al. Is Reoperative Laparoscopic Fundoplication an Effective Treatment for Previously Failed Anti-Reflux Procedures?. Clin Surg. 2019; 4: 2686..