Top

Published in:

01-03-2015

Reoperation rates after laparoscopic fundoplication

Authors: Tianzan Zhou, Cristina Harnsberger, Ryan Broderick, Hans Fuchs, Mark Talamini, Garth Jacobsen, Santiago Horgan, David Chang, Bryan Sandler

Published in: Surgical Endoscopy | Issue 3/2015

Abstract

Introduction

Current literature on redo antireflux surgery has limitations due to small sample size or single center experiences. This study aims to evaluate the reoperation rate of laparoscopic fundoplication in a large population database.

Methods

A longitudinal version of the California Office of Statewide Health Planning and Development database from 1995 to 2010 was used. Inclusion criteria were patients who received a laparoscopic fundoplication for uncomplicated gastroesophageal reflux disease (GERD) or hiatal hernia. Patients were excluded if they had complications of GERD, esophageal or gastric cancer, prior esophageal or gastric surgery, vagotomy, esophageal dysmotility, and diaphragmatic hernia with gangrene or obstruction. The outcome was reoperation, specified as another fundoplication or reversal. Analysis was carried out via a Kaplan–Meier plot, hazard curve, and multivariate analysis adjusting for age, race, gender, comorbidities, insurance status, hospital teaching status, and year of procedure.

Results

13,050 patients were included in the study. The 5 and 10-year cumulative reoperation rates were 5.2 % (95 % CI 4.8–5.7%) and 6.9 % (95 % CI 6.1–7.9%), respectively. Of these reoperations, 30 % were performed at a different hospital from that of the initial fundoplication. Reoperation rate was highest at 1 year post-operatively (1.7 % per year), and steadily declined until 4 years post-operatively, after which it remained at approximately 0.5 % per year. Multivariate analysis demonstrated significantly higher rates of reoperation among younger patients (HR = 3.56 for <30yo; HR = 1.89 for 30–50yo; HR = 1.65 for 50–65yo) and female patients (HR = 1.35).

Conclusions

Nearly one third of reoperations after failed laparoscopic fundoplication occur at a hospital different from the initial operation, which raises concern that existing literature does not reflect the true reoperation rate. The reoperation rate is highest in the first year postoperatively. The reasons for the higher rate of reoperation in females and younger patients remain unclear and warrant further study

Nissen R (1956) A simple operation for control of reflux esophagitis. Schweiz Med Wochenschr 86:590–592PubMed

Kahrilas PJ, Shaheen NJ, Vaezi MF et al (2008) American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology 135:1383–1391PubMedCrossRef

Peters JH, DeMeester TR (1996) Indications, benefits and outcome of laparoscopic Nissen fundoplication. Dig Dis 14(3):169–179PubMedCrossRef

Salminen P (2009) The laparoscopic Nissen fundoplication—a better operation? Surgeon. 7(4):224–227PubMedCrossRef

DeMeester TR et al (1986) Nissen fundoplication for gastroesophageal reflux disease: evaluation of primary repair in 100 consecutive patients. Ann Surg 204(1):19–20CrossRef

Grande L et al (1994) Value of Nissen fundoplication in patients with gastroesophageal reflux judged by long-term symptom control. Br J Surg 81(4):548–550PubMedCrossRef

Booth et al (2002) Results of laparoscopic Nissen fundoplication at 2–8 years after surgery. Br J Surg 89(4):476–481PubMedCrossRef

Anvari M, Allen C (2003) Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg 196(1):51–57PubMedCrossRef

Stein HJ et al (1996) Failure of antireflux surgery: causes and management strategies. Am J Surg 171(1):36–39PubMedCrossRef

10.

Dallemagne B et al (2011) Long-term results after laparoscopic reoperation for failed antireflux procedures. The British Journal of Surgery. 98(11):1581–1587PubMedCrossRef

11.

Horgan et al (1999) Failed antireflux surgery: what have we learned from reoperations? Arch Surg 134(8):809–815PubMedCrossRef

12.

Hatch K et al (2004) Failed fundoplications. Am J Surg 188(6):786–791PubMedCrossRef

13.

Lafullarde T et al (2001) Laparoscopic Nissen Fundoplication: five-year results and beyond. Arch Surg 136(2):180–184PubMedCrossRef

14.

Byrne JP et al (2005) Symptomatic and functional outcome after laparoscopic reoperation for failed antireflux surgery. Br J Surg 92(8):996–1001PubMedCrossRef

15.

Luostarinen ME et al (1993) Refundoplication for recurrent gastroesophageal reflux. World J Surg 17(5):587–593PubMedCrossRef

16.

Dutta et al (2004) Outcome of laparoscopic redo fundoplication. Surg Endosc 18(3):440–443PubMedCrossRef

17.

Mariette C et al (2011) Ambulatory laparoscopic fundoplication for gastroesophageal reflux disease: a systematic review. Surg Endosc 25(9):2859–2864PubMedCrossRef

18.

Funch-Jensen P et al (2008) Complications and frequency of redo antireflux surgery in Denmark: a nationwide study, 1997–2005. Surg Endosc 22(3):627–630PubMedCrossRef

Title: Reoperation rates after laparoscopic fundoplication
Authors: Tianzan Zhou
Cristina Harnsberger
Ryan Broderick
Hans Fuchs
Mark Talamini
Garth Jacobsen
Santiago Horgan
David Chang
Bryan Sandler
Publication date: 01-03-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3660-1

At a glance: The STEP trials

Springer Medicine

Reoperation rates after laparoscopic fundoplication

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2015

Percutaneous endoscopic caecostomy for severe constipation in adults: feasibility, durability, functional and quality of life results at 1 year follow-up

A comparative trial of laparoscopic magnetic sphincter augmentation and Nissen fundoplication

Surgical treatments for rectal prolapse: how does a perineal approach compare in the laparoscopic era?

The effect of duodenojejunostomy and sleeve gastrectomy on type 2 diabetes mellitus and gastrin secretion in Goto-Kakizaki rats

Surgical transgastric debridement of walled off pancreatic necrosis: an option for patients with necrotizing pancreatitis

Potential advantages of robotic radical gastrectomy for gastric adenocarcinoma in comparison with conventional laparoscopic approach: a single institutional retrospective comparative cohort study