Surgical Endoscopy

, Volume 10, Issue 3, pp 305–310

Causes of failures of laparoscopic antireflux operations

  • B. Dallemagne
  • J. M. Weerts
  • C. Jehaes
  • S. Markiewicz
Original Articles

DOI: 10.1007/BF00187377

Cite this article as:
Dallemagne, B., Weerts, J.M., Jehaes, C. et al. Surg Endosc (1996) 10: 305. doi:10.1007/BF00187377

Abstract

Background: Three factors determine the successful outcome after an antireflux operation for gastroesophageal reflux disease (GERD): indication for surgery, choice of the operative procedure, and quality of the operation. Laparoscopic treatment has not changed these concepts. The factor most likely to have been modified is the technical quality of the operative procedure. We evaluated 26 patients presenting with failure after laparoscopic antireflux surgery to determine the causes.

Methods: Nineteen patients came from our series of 503 laparoscopic antireflux procedures and seven patients were referred from other centers. Preoperative, peroperative, and postoperative data were retrospectively reviewed to analyze the responsible factor(s).

Results: Nine patients presented with a sphincter mechanism failure to control reflux, 14 patients had severe dysphagia, 3 patients presented with severe epigastric pain. The first operation was a Nissen-Rossetti fundoplication in 17 patients. The technical quality of the operative procedure was the responsible factor in 22/26 patients. The choice of the type of operation was questionable in five patients. Eight patients underwent successful endoscopic treatment, reoperation was necessary in 10 patients. Four patients underwent medical therapy, and four patients had no treatment.

Conclusions: The laparoscopic Nissen-Rossetti fundoplication was associated with a higher rate of failures, in terms of recurrent disease or severe dysphagia. The use of this technique was related to the laparoscopic inexperience of the surgeon, leading to a wrong application of the original procedure. Partial posterior fundoplication and total fundoplication with division of the short gastric vessels are obviously associated with a better outcome, if the selection of the operation is based on a strict preoperative physiopathological evaluation of the disease.

Key words

Laparoscopic antireflux Failure causes Antireflux operations 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Springer-Verlag New York Inc 1996

Authors and Affiliations

  • B. Dallemagne
    • 1
  • J. M. Weerts
    • 1
  • C. Jehaes
    • 1
  • S. Markiewicz
    • 1
  1. 1.Department de ChirurgieCentre Hospitalier Saint Joseph-EspéranceLiegeBelgium

Personalised recommendations