Abstract
Background
Obesity has been implicated as an important risk factor for fundoplication failure. However, the mechanism of fundoplication in obese patients is not fully understood. Our objective is to evaluate the patterns of failure in relation to the body mass index (BMI) undergoing re-operative intervention after failed fundoplication.
Methods
After Institutional Review Board approval, the patients who underwent re-operative intervention for failed fundoplication between November 2008 and December 2013 were identified. Patients were classified into three groups: non-obese, obese, and morbidly obese (<30, 30–35, >35 BMI, respectively). Pre-operative assessment and operative procedure performed were compared between the groups.
Results
One hundred twenty-four patients satisfied study criteria. Non-obese patients (53.2 %) had significantly more dysphagia as an indication for re-operative procedure (obese 31.6 %, p < 0.05; morbidly 16.7 %, p < 0.05). Obese and morbidly obese patients had significantly higher incidence of recurrent hiatal hernia than non-obese patients (88.7 vs. 65.6 %, p < 0.05). Morbidly obese patients had significantly higher incidence of disrupted fundoplication than non-obese patients (41.7 vs. 19.4 %, p < 0.05).
Conclusion
Similar anatomical failure patterns of state of fundoplication and recurrent hiatal hernia were noted between obese patients and morbidly obese patients and were distinct from non-obese patients.
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All authors have read the journal publication policy and have no conflicts of interest with regards to this paper.
Conflict of Interest
Drs. Akimoto, Nandipati, Kapoor, Yamamoto, Pallati, and Mittal have no conflicts of interest or financial ties to disclose.
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Akimoto, S., Nandipati, K.C., Kapoor, H. et al. Association of Body Mass Index (BMI) with Patterns of Fundoplication Failure: Insights Gained. J Gastrointest Surg 19, 1943–1948 (2015). https://doi.org/10.1007/s11605-015-2907-z
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DOI: https://doi.org/10.1007/s11605-015-2907-z