BACKGROUND: Redo fundoplication has acceptable outcomes in patients with failed previous fundoplications. However, a subset of patients require Roux-en-Y (RNY) reconstruction for symptom relief. AIM: The aim of this study was to demonstrate safety and efficacy of RNY reconstruction for failed fundoplications. METHOD: Retrospective review of data on patients who underwent short-limb RNY gastrojejunostomy (GJ) or esophagojejunostomy (EJ) between the years 2005 and 2007 was performed. RESULTS: Twenty-two patients underwent RNY reconstructions. Fourteen (64%) patients had one, six (27%) patients had two, and 2 (9%) patients had three previous anti-reflux procedures. RNY GJ was performed in 18 patients and EJ in four patients. Gastrectomy was performed in 13 of these patients. Seven patients (32%) had ten major or minor complications within the 30-day postoperative period, without any mortality observed. At a mean follow-up of 23 months, completed in 21 of these patients (95%), the average heartburn score was 0.38 (range, 0-2). The average regurgitation score was 0.23 (range, 0 to2) and the average dysphagia score was 0.7 (range, 0-2). The mean postoperative BMI was 25.4 compared to a preoperative BMI of 31. CONCLUSION: RNY reconstruction with GJ or EJ for failed anti-reflux procedures is a safe, valid surgical option in difficult situations, where a redo fundoplication is either non-feasible or expected to fail. However, it is associated with higher morbidity.
BACKGROUND: Redo fundoplication has acceptable outcomes in patients with failed previous fundoplications. However, a subset of patients require Roux-en-Y (RNY) reconstruction for symptom relief. AIM: The aim of this study was to demonstrate safety and efficacy of RNY reconstruction for failed fundoplications. METHOD: Retrospective review of data on patients who underwent short-limb RNY gastrojejunostomy (GJ) or esophagojejunostomy (EJ) between the years 2005 and 2007 was performed. RESULTS: Twenty-two patients underwent RNY reconstructions. Fourteen (64%) patients had one, six (27%) patients had two, and 2 (9%) patients had three previous anti-reflux procedures. RNY GJ was performed in 18 patients and EJ in four patients. Gastrectomy was performed in 13 of these patients. Seven patients (32%) had ten major or minor complications within the 30-day postoperative period, without any mortality observed. At a mean follow-up of 23 months, completed in 21 of these patients (95%), the average heartburn score was 0.38 (range, 0-2). The average regurgitation score was 0.23 (range, 0 to2) and the average dysphagia score was 0.7 (range, 0-2). The mean postoperative BMI was 25.4 compared to a preoperative BMI of 31. CONCLUSION: RNY reconstruction with GJ or EJ for failed anti-reflux procedures is a safe, valid surgical option in difficult situations, where a redo fundoplication is either non-feasible or expected to fail. However, it is associated with higher morbidity.
Authors: Galen A Ohnmacht; Claude Deschamps; Stephen D Cassivi; Francis C Nichols; Mark S Allen; Cathy D Schleck; Peter C Pairolero Journal: Ann Thorac Surg Date: 2006-06 Impact factor: 4.330
Authors: Scott G Houghton; Lana G Nelson; James M Swain; Elizabeth M Nesset; Michael L Kendrick; Geoffrey B Thompson; Michel M Murr; Francis C Nichols; Michael G Sarr Journal: Surg Obes Relat Dis Date: 2005-08-31 Impact factor: 4.734
Authors: Arja Gerritsen; Edgar J B Furnée; Hein G Gooszen; Maurits Wondergem; Eric J Hazebroek Journal: World J Surg Date: 2013-05 Impact factor: 3.352
Authors: András Légner; Kazuto Tsuboi; Lokesh Bathla; Tommy Lee; Lee E Morrow; Sumeet K Mittal Journal: Surg Endosc Date: 2010-11-05 Impact factor: 4.584
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: Joshua P Landreneau; Andrew T Strong; Matthew D Kroh; John H Rodriguez; Kevin El-Hayek Journal: Surg Endosc Date: 2019-07-25 Impact factor: 4.584