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Journal of Gastrointestinal Surgery

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01-11-2015 | Original Article

Association of Body Mass Index (BMI) with Patterns of Fundoplication Failure: Insights Gained

Authors: Shunsuke Akimoto, Kalyana C. Nandipati, Harit Kapoor, Se Ryung Yamamoto, Pradeep K. Pallati, Sumeet K. Mittal

Published in: Journal of Gastrointestinal Surgery | Issue 11/2015

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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Title: Association of Body Mass Index (BMI) with Patterns of Fundoplication Failure: Insights Gained
Authors: Shunsuke Akimoto
Kalyana C. Nandipati
Harit Kapoor
Se Ryung Yamamoto
Pradeep K. Pallati
Sumeet K. Mittal
Publication date: 01-11-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 11/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2907-z

At a glance: The STEP trials

Springer Medicine

Association of Body Mass Index (BMI) with Patterns of Fundoplication Failure: Insights Gained

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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