ArticleSurgical endoscopy2019
Roux-en-Y gastric bypass as a salvage procedure in complicated patients with failed fundoplication(s).
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Patients with Obesity Undergoing Roux-En-Y Gastric Bypass Versus Fundoplication for Refractory GERD: A Systematic Review and Meta-Analysis.Obesity surgery · 2026Pooled it
- Comparative Outcomes of Roux-en-Y Gastric Bypass and Fundoplication in Adults Living with Obesity and GERD: A Systematic Review and Meta-analysis.Obesity surgery · 2026Pooled it
- Efficacy and safety of laparoscopic Roux-en-Y gastric bypass in symptomatic patients following fundoplication failure: a meta-analysis.Esophagus : official journal of the Japan Esophageal Society · 2023Pooled it
- Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Risk-Adjusted Safety Profiles after Previous Fundoplication: A 499-Patient MBSAQIP Analysis.Obesity surgery · 2026Article
- Robotic revision surgery after failed Nissen anti-reflux surgery: a single center experience and a literature review.Journal of robotic surgery · 2023Review
- Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD).Surgical endoscopy · 2023Article
- Redo fundoplication and early Roux-en-Y diversion for failed fundoplication: a 3-year single-center experience.Surgical endoscopy · 2022Article
- LAPAROSCOPIC REDO FUNDOPLICATION ALONE, REDO NISSEN FUNDOPLICATION, OR TOUPET FUNDOPLICATION COMBINED WITH ROUX-EN-Y DISTAL GASTRECTOMY FOR TREATMENT OF FAILED NISSEN FUNDOPLICATION.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022Article
- Minimally invasive Roux-en-Y reconstruction as a salvage operation after failed nissen fundoplication.Surgical endoscopy · 2020Article
- Long-term consequences of one anastomosis gastric bypass on esogastric mucosa in a preclinical rat model.Scientific reports · 2020Article
- Salvage Options for Fundoplication Failure.Current gastroenterology reports · 2019Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn symptomatic patients after failed fundoplication, reoperation is considered. In complex or obese patients, Roux-en Y gastric bypass (RYGB) may be the best operation. We sought to characterize the outcomes of patients with failed fundoplication to undergo salvage RYGB, and to compare these outcomes to patients undergoing reoperative fundoplication.
methodsA prospectively maintained database was queried for procedures performed at a single institution from 2011 to 2017. GERD health-related quality of life (HRQL) surveys were administered at defined intervals.
resultsThirty-six patients underwent salvage RYGB and 84 patients underwent reoperative fundoplication. The RYGB cohort had a higher BMI (35.5 ± 6.8 vs. 28.7 ± 5.3, p < 0.01), more gastroparesis (52.8% vs. 9.5%, p < 0.01), more esophagitis (42.9% vs. 20.2%, p = 0.01), and more prior fundoplications (1.9 vs. 1.2, p < 0.01). The incidence of gastroparesis and esophagitis was directly related to the number of failed fundoplications (p < 0.05). Operative times were longer with RYGB (332.7 ± 131.5 vs. 200.0 ± 67.6 min, p < 0.01) as was length of stay (4.3 ± 3.4 vs. 2.8 ± 1.5 days, p = 0.02), incidence of Clavien-Dindo complications ≥ Grade 3 (19.4% vs. 4.8%, p = 0.01), 30-day reoperation (11.1% vs. 1.2%, p = 0.01), and 30-day readmission (32.4% vs. 11.9%, p < 0.01). In five patients with three or more prior fundoplication attempts, an esophagojejunostomy was necessary. If these patients are excluded, there was no difference for RYGB with gastrojejunostomy compared to reoperative fundoplication for complications, reoperations, or readmissions. GERD-HRQL scores were similar prior to surgery in both cohorts and improved significantly and to a similar degree on long-term follow-up.
conclusionsIn a complex cohort of patients with high rates of obesity and numerous failed previous fundoplication attempts, conversion to RYGB results in good symptomatic outcomes. Patients with three or more previous fundoplication attempts are more likely to require esophagojejunostomy. Complication rates in this subset of patients appear to be quite high.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.