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Salvage Options for Fundoplication Failure

  • Esophagus (J Clarke and N Ahuja, Section Editors)
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Abstract

Purpose of Review

Gastroesophageal reflux disease (GERD) affects millions of people worldwide. Many patients with medically refractory symptoms ultimately undergo antireflux surgery, most often with a laparoscopic fundoplication. Symptoms related to GERD may persist or recur. Revisional surgery is necessary in some patients.

Recent Findings

A reoperative fundoplication is the most commonly performed salvage procedure for failed fundoplication. Although redo fundoplication has been reported to have increased risk of morbidity compared with primary cases, increasing experience with the minimally invasive approach to reoperative surgery has significantly improved patient outcome with acceptable resolution of reflux symptoms in the majority of patients.

Summary

Recurrence of reflux symptoms after an initial fundoplication requires a thorough work-up and a thoughtful approach. While reoperative fundoplication is the most common procedure performed, there are other options and the treatment should be tailored to the patient, their history, and the mechanism of fundoplication failure.

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  1. Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA

    Semeret Munie & Jon C. Gould

  2. Department of General Surgery, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202, USA

    Hassan Nasser

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Munie, S., Nasser, H. & Gould, J.C. Salvage Options for Fundoplication Failure. Curr Gastroenterol Rep 21, 41 (2019). https://doi.org/10.1007/s11894-019-0709-2

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