Background
Surgical remedy for failed anti-reflux surgery is a successful choice.
Patients and methods
The study was conducted at the General Surgery Department of Ain Shams University Hospitals during the period from October 2018 to December 2020. It included 20 patients with recurrent gastroesophageal reflux disease after failed previous anti-reflux surgery to evaluate the outcomes of redo anti-reflux surgery in recurrent cases and to determine the feasibility, safety, and efficacy of the procedures.
Results
The initial procedure in these patients was laparoscopic Nissen fundoplication. In all, 24 patients were included, but after esophageal motility study (manometry) four of them had a functional (motility) disorder and were excluded from our study. So, only 20 patients were studied. The causes of failure were migration (eight patients), disruption (three patients), migration with disruption (seven patients), and high BMI (two patients). The surgical remedy options done were hiatal repair, rewrap, hiatal repair and rewrap, and gastric bypass, respectively. No mortality was reported and the complications were minor. Postoperative follow-up showed significant improvement in symptoms and patient satisfaction.
Conclusion
Laparoscopic remedy for failed anti-reflux surgery is a feasible, safe choice in treating recurrent gastroesophageal reflux disease. It shows promising results and should be offered to patients with recurrence.