Abstract
In the course of approximately 350 operations for gastroesophageal reflux and 1,500 evaluations of patients previously operated on or being assessed for therapy, a number of complications and undesirable side effects of antireflux surgery have been encountered. This report describes unfavorable outcomes including postoperative dysphagia, “gas-bloat syndrome,” postoperative gastric dilatation, unplanned vagotomy, failure to relieve symptoms, persistence or recurrence of reflux or hiatal hernia, perforation of the esophagus or stomach, postoperative bleeding, unplanned splenectomy, and persistence of stricture, which have followed the antireflux repairs introduced by Belsey, Nissen, or Hill, the gastroplasty procedures described by Thal, and by Collis, intrathoracic fundoplication, and esophageal resection with gastrointestinal interposition.
Keywords
Cardiac Surgery Vascular Surgery Thoracic Surgery General Surgery Hiatal HerniaRésumé
Dans les suites de quelques 350 opérations pour reflux gastro-oesophagien et au cours de 1,500 examens de malades opérés ou mis au point en vue d'un traitement, nous avons observé un certain nombre de complications et de séquelles de la chirurgie anti-reflux. Le présent travail les décrit: vagotomie accidentelle, perforation de l'oesophage ou de l'estomac, splénectomie inutile, dilatation gastrique aigüe et hémorragie postopératoire, dysphagie postopératoire, syndrome de distension gastrique, persistance des symptomes préopératoires, persistance ou récidive du reflux ou de la hernie hiatale, persistance de la sténose. Ces complications ont été observées après diverses interventions: plastics anti-reflux de types Belsey, Nissen ou Hill, gastroplasties de types Thal ou Collis, fundoplicature intrathoracique, résection oesophagienne avec interposition jéjunale.
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References
- 1.Skinner, D.B., Belsey, R.H.R.: Surgical management of esophageal reflux and hiatus hernia. J. Thorac. Cardiovasc. Surg.53:33, 1967PubMedGoogle Scholar
- 2.Nissen, R.: Gastropexy and “fundoplication” in surgical treatment of hiatal hernia. Am. J. Dig. Dis.6:954, 1961PubMedGoogle Scholar
- 3.Hill, L.D.: An effective operation for hiatal hernia: An eight-year appraisal. Ann. Surg.166:681, 1967PubMedGoogle Scholar
- 4.Thal, A.T., Hatafuku, T., Kurtzman, R.: New operation for distal esophageal stricture. Arch. Surg.90:464, 1965PubMedGoogle Scholar
- 5.Collis, J.L.: An operation for hiatus hernia with short esophagus. J. Thorac. Cardiovasc. Surg.34:768, 1957Google Scholar
- 6.Safaie-Shiraze, S., Zike, W.L., Anuras, S., Condon, R.E., DenBesten, L.: Nissen fundoplication without crural repair. Arch. Surg.108:4, 1974Google Scholar
- 7.Belsey, R.: Reconstruction of the esophagus with left colon. J. Thorac. Cardiovasc. Surg.49:1, 1965PubMedGoogle Scholar
- 8.Schatzki, R.: The lower esophageal ring (long-term follow-up of symptomatic and asymptomatic rings). Am. J. Roentgenol. Radium Ther. Nucl. Med.90:805, 1963PubMedGoogle Scholar
- 9.Woodward, E.R., Thomas, H.F., McAlhany, J.C.: Comparison of crural repair and Nissen fundoplication in the treatment of esophageal hiatus hernia with peptic esophagitis. Ann. Surg.173:783, 1971Google Scholar
- 10.DeMeester, T.R., Johnson, L.F., Joseph, G.J., Toscano, M.S., Hall, A.W., Skinner, D.B.: Patterns of gastroesophageal reflux in health and disease. Ann. Surg.184:459, 1976PubMedGoogle Scholar
- 11.Skinner, D.B., Booth, D.J.: Assessment of distal esophageal function in patients with hiatal hernia and/or gastroesophageal reflux. Ann. Surg.172:627, 1970PubMedGoogle Scholar
- 12.Johnson, L.F., DeMeester, T.R.: Twenty-four hour pH monitoring of the distal esophagus: A quantitative measure of gastroesophageal reflux. Am. J. Gastroenterol.62:325, 1974PubMedGoogle Scholar
- 13.Hill, L.D.: Surgery and gastroesophageal reflux. Gastroenterology63:183, 1972PubMedGoogle Scholar
- 14.Heimlich, H.J.: Esophagoplasty with reversed gastric tube. Review of 53 cases. Am. J. Surg.123:80, 1972PubMedGoogle Scholar
- 15.Hollenbeck, J.I., Woodward, E.R.: Treatment of peptic esophageal stricture with combined fundic patchfundoplication. Ann. Surg.182:472, 1975PubMedGoogle Scholar
- 16.Jones, E.L., Booth, D.J., Cameron, J.L., Zuidema, G.D., Skinner, D.B.: Functional evaluation of esophageal reconstructions. Ann. Thorac. Surg.12:4, 1971Google Scholar
- 17.Pearson, F.G., Henderson, R.D., Parrish, R.M.: An operative technique for the control of reflux following esophagogastrostomy. J. Thorac. Cardiovasc. Surg.58:668, 1969PubMedGoogle Scholar
- 18.Merendino, K.A., Dillard, D.H.: The concept of sphincter substitution by an interposed jejunal segment for anatomic and physiological abnormalities at the esophagogastric junction; with special reference to reflux esophagitis, cardiospasm and esophageal varices. Ann. Surg.142:486, 1955PubMedGoogle Scholar