Back to Search
Start Over
Roux-en-Y near esophagojejunostomy for failed antireflux operations: outcomes in more than 100 patients
- Source :
- The Annals of thoracic surgery. 98(6)
- Publication Year :
- 2013
-
Abstract
- Intractable gastroesophageal reflux disease (GERD) after antireflux operations presents a challenge-particularly in obese patients and patients with esophageal dysmotility-and increases the complexity of the redo operation. This study evaluated the results of Roux-en-Y near esophagojejunostomy (RNYNEJ) in the management of recurrent GERD after antireflux operations.We conducted a retrospective review of overweight patients with intractable GERD who underwent RNYNEJ for failed antireflux operations. We evaluated perioperative outcomes, dysphagia (ranging from 1 = no dysphagia to 5 = unable to swallow saliva), and quality of life (QOL) (assessed using the GERD health-related quality-of-life instrument (HRQOL).Over a 12-year period, 105 patients with body mass index (BMI) greater than 25 underwent RNYNEJ for failed antireflux operations. Most were obese (BMI30; 82 patients [78%]); esophageal dysmotility was demonstrated in more than one-third of patients. Forty-eight (46%) patients had multiple antireflux operations before RNYNEJ, and 27 patients had undergone a previous Collis gastroplasty. There was no perioperative mortality. Major complications, including anastomotic leak requiring surgical intervention (n = 3 [2.9%]), were noted in 25 patients (24%).The median length of stay was 6 days. During follow-up (mean, 23.39 months), median BMI decreased from 35 to 27.6 (p0.0001), and the mean dysphagia score decreased from 2.9 to 1.5 (p0.0001). The median GERD HRQOL score, assessed in a subset of patients, was 9 (classified as excellent).RNYNEJ for persistent GERD after antireflux operations in appropriately selected patients can be performed safely with good results in experienced centers. RNYNEJ should be considered an important option for the treatment of intractable recurrent symptoms after antireflux operations, particularly in obese patients.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Male
Reoperation
medicine.medical_specialty
Jejunostomy
Anastomosis
Young Adult
Esophagus
Quality of life
otorhinolaryngologic diseases
medicine
Humans
Treatment Failure
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Retrospective cohort study
Anastomosis, Roux-en-Y
Perioperative
Length of Stay
Middle Aged
medicine.disease
Dysphagia
Roux-en-Y anastomosis
humanities
digestive system diseases
Surgery
Jejunum
Treatment Outcome
Patient Satisfaction
GERD
Gastroesophageal Reflux
Quality of Life
Female
Laparoscopy
Collis gastroplasty
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Forecasting
Subjects
Details
- ISSN :
- 15526259
- Volume :
- 98
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The Annals of thoracic surgery
- Accession number :
- edsair.doi.dedup.....823bca111c1e0951f1c0acbf24ec837a