ArticleSurgical endoscopy2019
Strategies for surgical remediation of the multi-fundoplication failure patient.
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 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Is Roux-en-Y gastrojejunostomy an adequate anti-reflux operation after esophagogastric myotomy?Surgical endoscopy · 2025Article
- Outcomes of esophagectomy in patients with previous foregut surgery: a matched retrospective cohort study.Surgical endoscopy · 2025Article
- Robotic versus laparoscopic revision to Toupet fundoplication for failed Nissen fundoplication: a single-center experience.Journal of robotic surgery · 2024Article
- Does crural repair with biosynthetic mesh improve outcomes of revisional surgery for recurrent hiatal hernia?Hernia : the journal of hernias and abdominal wall surgery · 2024Observational
- Risk factors for adverse outcomes following paraesophageal hernia repair among obese patients.Surgical endoscopy · 2023Article
- ChatGPT: Friend or foe in medical writing? An example of how ChatGPT can be utilized in writing case reports.Surgery in practice and science · 2023Article
- Redo fundoplication vs. Roux-en-Y gastric bypass conversion for failed anti-reflux surgery: which is better?Surgical endoscopy · 2023Article
- Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD).Surgical endoscopy · 2023Article
- Third-time ("redo-redo") anti-reflux surgery: patient-reported outcomes after a thoracoabdominal approach.Surgical endoscopy · 2020Article
- Salvage Options for Fundoplication Failure.Current gastroenterology reports · 2019Review
- Association of preoperative workup and comorbidities with risk of gastroesophageal surgery failure.Annals of gastroenterologyArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOutcomes are not well studied in patients undergoing remediation for multi-fundoplication failure, that is, two or more prior failed fundoplications. Re-operation must balance reflux control and restoration of the ability to eat with the challenge of reconstructing a distorted hiatus and GE junction. The purpose of this study is to present our experience with surgical remediation for multi-fundoplication failure.
methodsMedical records were retrospectively reviewed of 91 patients who underwent third time or more esophagogastric operation for fundoplication failure at a single institution from 2007 to 2016. Dysphagia was present in 56% and heartburn in 51%. Median number of prior operations was 2 with range up to 6. Anatomic failure consisted of slipped wrap in 26 cases, wrap herniation in 23, hiatal stenosis in 24, hiatal mesh complication in 8, and wrap dehiscence in 10. Operative approaches generally followed an institutional algorithm and consisted of hiatal hernia repair with: re-do fundoplication in 55%, takedown of fundoplication alone in 24%, Roux-en-Y gastrojejunostomy in 14%, and GE junction resection in 7%. Laparoscopic approach was successful in 81%.
resultsMean duration of operations was 217 min and median length of stay was 3 days. The complication rate was 13%, with 7% undergoing unplanned early re-operation. Patients were followed for mean 11 months, and recurrent hiatal hernia was detected in 13%. Late re-operation was performed in 6% for recurrent hiatal hernia. Recurrent reflux symptomatology resolved in 93%. Dysphagia resolved in 84%. There were no significant differences in outcomes with regard to number of prior operations, operative approach, BMI, or age.
conclusionsThere is no single best approach to remediation in the multi-fundoplication failure patient. Re-do fundoplication is appropriate in over half of patients. Reoperation for multi-fundoplication failure can be performed via minimally invasive approach with excellent remediation of symptoms, low morbidity, and low recurrence rates.
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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.