BACKGROUND: Some patients develop troublesome dysphagia after laparoscopic antireflux surgery, and a proportion require further intervention. The management of this problem was evaluated. METHODS: Patients who underwent intervention for dysphagia after laparoscopic fundoplication were identified from a database. Outcomes were prospectively determined from a standardized questionnaire that evaluated symptoms scores for dysphagia for solids and liquids, as well as patient satisfaction with the overall outcome. Outcomes 1 year after reintervention, and at the most recent follow-up were evaluated. RESULTS: From 1994 to 2009, 121 (6.6%) of 1,821 patients who underwent laparoscopic fundoplication for gastroesophageal reflux also underwent endoscopic or surgical reintervention for dysphagia. Of these 121 patients, 56 underwent endoscopic dilatation, and 24 were satisfied with the outcome of dilatation; 18 progressed to surgery, and dysphagia persisted in 14 of them. Overall, 83 patients underwent revisional surgery, and 47 (62.7%) were satisfied with the outcome. Compared to patients who did not undergo any intervention for dysphagia, patients who underwent reintervention had lower satisfaction scores and higher dysphagia scores. CONCLUSIONS: Approximately two thirds of patients with troublesome post-fundoplication dysphagia have a satisfactory outcome following either endoscopic dilatation or revisional surgery. However, approximately one third continue to be troubled by symptoms, despite further intervention.
BACKGROUND: Some patients develop troublesome dysphagia after laparoscopic antireflux surgery, and a proportion require further intervention. The management of this problem was evaluated. METHODS:Patients who underwent intervention for dysphagia after laparoscopic fundoplication were identified from a database. Outcomes were prospectively determined from a standardized questionnaire that evaluated symptoms scores for dysphagia for solids and liquids, as well as patient satisfaction with the overall outcome. Outcomes 1 year after reintervention, and at the most recent follow-up were evaluated. RESULTS: From 1994 to 2009, 121 (6.6%) of 1,821 patients who underwent laparoscopic fundoplication for gastroesophageal reflux also underwent endoscopic or surgical reintervention for dysphagia. Of these 121 patients, 56 underwent endoscopic dilatation, and 24 were satisfied with the outcome of dilatation; 18 progressed to surgery, and dysphagia persisted in 14 of them. Overall, 83 patients underwent revisional surgery, and 47 (62.7%) were satisfied with the outcome. Compared to patients who did not undergo any intervention for dysphagia, patients who underwent reintervention had lower satisfaction scores and higher dysphagia scores. CONCLUSIONS: Approximately two thirds of patients with troublesome post-fundoplication dysphagia have a satisfactory outcome following either endoscopic dilatation or revisional surgery. However, approximately one third continue to be troubled by symptoms, despite further intervention.
Authors: Navreet Malhi-Chowla; Piotr Gorecki; Tanja Bammer; Sami R Achem; Ronald A Hinder; Kenneth R Devault Journal: Gastrointest Endosc Date: 2002-02 Impact factor: 9.427
Authors: E Guérin; K Bétroune; J Closset; A Mehdi; J C Lefèbvre; J J Houben; M Gelin; P Vaneukem; I El Nakadi Journal: Surg Endosc Date: 2007-11 Impact factor: 4.584
Authors: Jamie J Kelly; David I Watson; Kin Fah Chin; Peter G Devitt; Philip A Game; Glyn G Jamieson Journal: J Am Coll Surg Date: 2007-08-23 Impact factor: 6.113
Authors: Karl Hermann Fuchs; Benjamin Babic; Wolfram Breithaupt; Bernard Dallemagne; Abe Fingerhut; Edgar Furnee; Frank Granderath; Peter Horvath; Peter Kardos; Rudolph Pointner; Edoardo Savarino; Maud Van Herwaarden-Lindeboom; Giovanni Zaninotto Journal: Surg Endosc Date: 2014-05-02 Impact factor: 4.584