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Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/58235

Type: Journal article
Title: Early reoperation after laparoscopic fundoplication: The importance of routine postoperative contrast studies
Author: Tsunoda, Shigeru
Jamieson, Glyn Garfield
Devitt, Peter Geoffrey
Watson, David Ian
Thompson, Sarah Kathryn
Citation: World Journal of Surgery, 2010; 34(1):79-84
Publisher: Springer
Issue Date: 2010
ISSN: 0364-2313
School/Discipline: School of Medicine : Surgery
Statement of
Responsibility: 
Shigeru Tsunoda, Glyn G. Jamieson, Peter G. Devitt, David I. Watson and Sarah K. Thompson
Abstract: Background: The necessity for routine postoperative contrast studies following laparoscopic fundoplication for either gastroesophageal reflux disease or paraesophageal hernia is unclear. Methods: To determine whether a routine contrast X-ray film influenced surgical decision making following laparoscopic fundoplication, we reviewed records from a prospective database of 1,894 patients who underwent a primary laparoscopic fundoplication for gastroesophageal reflux disease or paraesophageal hernia between October 1991 and June 2008, and identified those who underwent early reoperation. The value of early routine postoperative barium swallow examinations in the management of these patients was then determined. Results: The review showed that 53 patients (2.8%) underwent reoperative procedures within seven days of their original operation: 21 had originally undergone surgery for a paraesophageal hernia, and 32 for reflux. Of the 53 patients who underwent reoperaiton, 25 (47.2%) were treated for dysphagia, 17 (32.1%) for acute paraesophageal hernia, 6 (11.3%) for a gastrointestinal leak, and 5 (9.4%) for bleeding or peritonitis. Fifteen of the 17 patients who underwent repair of an acute hiatus hernia (0.8% of all patients) had no symptoms and underwent reoperative surgery because of radiological findings alone. Primary surgery for a large hiatus hernia was associated with a higher incidence of early reoperation (5.2 vs. 2.2%; P = 0.001). Conclusions: Approximately 1 in 125 patients who underwent laparoscopic surgery for reflux or a large hiatus hernia had an important finding on an early postoperative contrast swallow, and benefited from this investigation by undergoing early reoperative intervention.
Rights: Copyright Societe Internationale de Chirurgie 2009
RMID: 0020093614
DOI: 10.1007/s00268-009-0217-x
Appears in Collections:Surgery (RAH) Publications
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