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Type: Journal article
Title: Long-term outcomes of revisional surgery following laparoscopic fundoplication
Author: Lamb, P.
Myers, J.
Jamieson, G.
Thompson, S.
Devitt, P.
Watson, D.
Citation: British Journal of Surgery, 2009; 96(4):391-397
Publisher: John Wiley & Sons Ltd
Issue Date: 2009
ISSN: 0007-1323
Statement of
P. J. Lamb, J. C. Myers, G.G. Jamieson, S. K. Thompson, P. G.Devitt and D. I. Watson
Abstract: <h4>Background</h4>A small proportion of patients who have laparoscopic antireflux procedures require revisional surgery. This study investigated long-term clinical outcomes.<h4>Methods</h4>Patients requiring late revisional surgery following laparoscopic fundoplication for gastro-oesophageal reflux were identified from a prospective database. Long-term outcomes were determined using a questionnaire evaluating symptom scores for heartburn, dysphagia and satisfaction.<h4>Results</h4>The database search found 109 patients, including 98 (5.6 per cent) of 1751 patients who had primary surgery in the authors' unit. Indications for surgical revision were dysphagia (52 patients), recurrent reflux (36), mechanical symptoms related to paraoesophageal herniation (16) and atypical symptoms (five). The median time to revision was 26 months. Outcome data were available for 104 patients (median follow-up 66 months) and satisfaction data for 102, 88 of whom were highly satisfied (62.7 per cent) or satisfied (23.5 per cent) with the outcome. Patients who had revision for dysphagia had a higher incidence of poorly controlled heartburn (20 versus 2 per cent; P = 0.004), troublesome dysphagia (16 versus 6 per cent; P = 0.118) and a lower satisfaction score (P = 0.023) than those with recurrent reflux or paraoesophageal herniation.<h4>Conclusion</h4>Revisional surgery following laparoscopic fundoplication can produce good long-term results, but revision for dysphagia has less satisfactory outcomes.
Keywords: Humans
Deglutition Disorders
Gastroesophageal Reflux
Treatment Outcome
Middle Aged
Patient Satisfaction
Young Adult
DOI: 10.1002/bjs.6486
Appears in Collections:Aurora harvest 5
Surgery publications

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