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Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure.
Surg Endosc. 2003 May; 17(5):704-7.SE

Abstract

BACKGROUND

Laparoscopic Nissen fundoplication as treatment for gastroesophageal reflux disease (GERD) in adults has a reported recurrence rate of 2-17%. We investigated the rates and mechanisms of failure after laparoscopic Nissen fundoplication in children.

METHODS

All patients who underwent a laparoscopic Nissen fundoplication for GERD and who subsequently required a redo Nissen were reviewed (n = 15). The control group consisted of the most recent 15 patients who developed recurrent GER after an open Nissen, fundoplication.

RESULTS

Between 1994 and 2000, laparoscopic Nissen fundoplication was performed in 179 patients. Fifteen patients (8.7%) underwent revision. The mechanisms of failure were herniation in four patients, wrap dehiscence in four, a too-short wrap in three, a loosened wrap in two, and other reasons in two. The reoperation was performed laparoscopically in five patients (33%). The failure mechanisms were different in the open patients: eight were due to slipped wraps; three to dehiscences; and two to herniations.

CONCLUSION

The failure rate after laparoscopic Nissen is acceptably low. A redo laparoscopic Nissen can be performed safely after an initial laparoscopic approach.

Authors+Show Affiliations

Graziano K
Department of Surgery, Section of Pediatric Surgery, the C. S. Mott Children's Hospital, University of Michigan, F3970, Box 0245, Ann Arbor, MI 48109, USA.
Teitelbaum DH
No affiliation info available
McLean K
No affiliation info available
Hirschl RB
No affiliation info available
Coran AG
No affiliation info available
Geiger JD
No affiliation info available

MeSH

ChildChild, PreschoolFundoplicationGastroesophageal RefluxHernia, HiatalHumansLaparoscopyPostoperative ComplicationsRecurrenceReoperationRetrospective StudiesTreatment Failure

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12618950

Citation

Graziano, K, et al. "Recurrence After Laparoscopic and Open Nissen Fundoplication: a Comparison of the Mechanisms of Failure." Surgical Endoscopy, vol. 17, no. 5, 2003, pp. 704-7.
Graziano K, Teitelbaum DH, McLean K, et al. Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surg Endosc. 2003;17(5):704-7.
Graziano, K., Teitelbaum, D. H., McLean, K., Hirschl, R. B., Coran, A. G., & Geiger, J. D. (2003). Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surgical Endoscopy, 17(5), 704-7.
Graziano K, et al. Recurrence After Laparoscopic and Open Nissen Fundoplication: a Comparison of the Mechanisms of Failure. Surg Endosc. 2003;17(5):704-7. PubMed PMID: 12618950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. AU - Graziano,K, AU - Teitelbaum,D H, AU - McLean,K, AU - Hirschl,R B, AU - Coran,A G, AU - Geiger,J D, Y1 - 2003/03/07/ PY - 2002/10/29/received PY - 2002/11/05/accepted PY - 2003/3/6/pubmed PY - 2003/8/30/medline PY - 2003/3/6/entrez SP - 704 EP - 7 JF - Surgical endoscopy JO - Surg Endosc VL - 17 IS - 5 N2 - BACKGROUND: Laparoscopic Nissen fundoplication as treatment for gastroesophageal reflux disease (GERD) in adults has a reported recurrence rate of 2-17%. We investigated the rates and mechanisms of failure after laparoscopic Nissen fundoplication in children. METHODS: All patients who underwent a laparoscopic Nissen fundoplication for GERD and who subsequently required a redo Nissen were reviewed (n = 15). The control group consisted of the most recent 15 patients who developed recurrent GER after an open Nissen, fundoplication. RESULTS: Between 1994 and 2000, laparoscopic Nissen fundoplication was performed in 179 patients. Fifteen patients (8.7%) underwent revision. The mechanisms of failure were herniation in four patients, wrap dehiscence in four, a too-short wrap in three, a loosened wrap in two, and other reasons in two. The reoperation was performed laparoscopically in five patients (33%). The failure mechanisms were different in the open patients: eight were due to slipped wraps; three to dehiscences; and two to herniations. CONCLUSION: The failure rate after laparoscopic Nissen is acceptably low. A redo laparoscopic Nissen can be performed safely after an initial laparoscopic approach. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/12618950/Recurrence_after_laparoscopic_and_open_Nissen_fundoplication:_a_comparison_of_the_mechanisms_of_failure_ DB - PRIME DP - Unbound Medicine ER -