BACKGROUND: Reoperative antireflux surgery is complex and traditionally performed by open methods. Increasingly, surgeons are performing minimally invasive reoperations. This report summarizes our experience with laparoscopic reoperative antireflux surgery (LRAS). METHODS: A retrospective review (1996 to 2001) identified 80 LRAS cases. Median age was 49 (22 to 80) years with 52 females and 28 males. Primary symptoms included heartburn (53%), regurgitation (22%), and dysphagia (25%). Detailed outcomes recorded at follow-up included heartburn severity using the Gastroesophageal Reflux Disease-Health Related Quality of Life scale (HRQOL) and SF36 physical (PCS) and mental (MCS) component summary scores. RESULTS: LRAS was completed in 97.5% of cases (two conversions). The most common problems identified were mediastinal migration of the wrap in 48 (60%) and misplaced wrap in 11 (13.8%). LRAS operations included Collis-Nissen (42), Nissen (26), Toupet (six), and six others. Pyloroplasty was required in nine (11%). Complications occurred in 16 patients. These included nine minor gastric perforations (all repaired intraoperatively) and two reoperations for complications (1 patient with a bile leak and the second with a pyloroplasty site leak). Median length of stay was 2.5 days. Median follow-up was 18 (1 to 52) months; 18 (23%) required proton-pump inhibitors. Detailed outcomes were available in 50 patients. Mean PCS and MCS scores were 42 and 47, respectively (normals = 50). HRQOL scores were excellent in 35 (65%), satisfactory in 9 (17%), and poor in 10 (18%). Ten patients (18%) reported that they were dissatisfied. CONCLUSIONS: LRAS can be performed safely with complication and success rates similar to open operations in a center with extensive laparoscopic experience.
BACKGROUND: Reoperative antireflux surgery is complex and traditionally performed by open methods. Increasingly, surgeons are performing minimally invasive reoperations. This report summarizes our experience with laparoscopic reoperative antireflux surgery (LRAS). METHODS: A retrospective review (1996 to 2001) identified 80 LRAS cases. Median age was 49 (22 to 80) years with 52 females and 28 males. Primary symptoms included heartburn (53%), regurgitation (22%), and dysphagia (25%). Detailed outcomes recorded at follow-up included heartburn severity using the Gastroesophageal Reflux Disease-Health Related Quality of Life scale (HRQOL) and SF36 physical (PCS) and mental (MCS) component summary scores. RESULTS: LRAS was completed in 97.5% of cases (two conversions). The most common problems identified were mediastinal migration of the wrap in 48 (60%) and misplaced wrap in 11 (13.8%). LRAS operations included Collis-Nissen (42), Nissen (26), Toupet (six), and six others. Pyloroplasty was required in nine (11%). Complications occurred in 16 patients. These included nine minor gastric perforations (all repaired intraoperatively) and two reoperations for complications (1 patient with a bile leak and the second with a pyloroplasty site leak). Median length of stay was 2.5 days. Median follow-up was 18 (1 to 52) months; 18 (23%) required proton-pump inhibitors. Detailed outcomes were available in 50 patients. Mean PCS and MCS scores were 42 and 47, respectively (normals = 50). HRQOL scores were excellent in 35 (65%), satisfactory in 9 (17%), and poor in 10 (18%). Ten patients (18%) reported that they were dissatisfied. CONCLUSIONS: LRAS can be performed safely with complication and success rates similar to open operations in a center with extensive laparoscopic experience.
Authors: Andrew T Strong; Joshua P Landreneau; Michael Cline; Matthew D Kroh; John H Rodriguez; Jeffrey L Ponsky; Kevin El-Hayek Journal: J Gastrointest Surg Date: 2019-02-26 Impact factor: 3.452
Authors: Sumeet K Mittal; András Légner; Kazuto Tsuboi; Arpad Juhasz; Lokesh Bathla; Tommy H Lee Journal: Surg Endosc Date: 2012-10-06 Impact factor: 4.584
Authors: Kathleen M Coakley; Steven A Groene; Paul D Colavita; Tanushree Prasad; Dimitris Stefanidis; Amy E Lincourt; Vedra A Augenstein; Keith Gersin; B Todd Heniford Journal: Surg Endosc Date: 2018-01-23 Impact factor: 4.584
Authors: Miller Carlton Hamrick; Steven S Davis; Amar Chiruvella; Rebecca L Coefield; J Patrick Waring; John F Sweeney; Edward Lin Journal: J Gastrointest Surg Date: 2012-08-16 Impact factor: 3.452
Authors: Constantine T Frantzides; Atul K Madan; Mark A Carlson; Tallal M Zeni; John G Zografakis; Ronald M Moore; Mick Meiselman; Minh Luu; Georgios D Ayiomamitis Journal: J Laparoendosc Adv Surg Tech A Date: 2009-04 Impact factor: 1.878
Authors: Se Ryung Yamamoto; Masato Hoshino; Kalyana C Nandipati; Tommy H Lee; Sumeet K Mittal Journal: Surg Endosc Date: 2013-10-03 Impact factor: 4.584