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LAPAROSCOPIC SURGERY REINTERVENTION OF ANTI-REFLUX SURGERY: A SYSTEMATIC REVIEW
EP31025
Poster Title: LAPAROSCOPIC SURGERY REINTERVENTION OF ANTI-REFLUX SURGERY: A SYSTEMATIC REVIEW
Submitted on 23 Nov 2019
Author(s): Campos-Badillo Julio Adan, López-Olivera Karen Denisse
Affiliations:
This poster was presented at 27th International Congress of the European Association for Endoscopic Surgery (EAES) Sevilla, Spain, 12–15 June 2019
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Poster Information
Abstract: Objective: :Evaluate the currently literature about antireflux surgery reinter- vention, focusing on the main indications of re-intervention, type of approach and morbidity and mortality of laparoscopic antireflux surgery.

Material and Methods: A literature search was conducted in two electronic databases, MED- LINE and EMBASE. The search was limited to the period 2009 to 2016. Terms were used in relation to the procedure or intervention and the underlying disease. We chose observational studies (cohort, cases and controls and series of cases), where the main indication for antireflux surgery would have been gastroesophageal reflux disease.

Results: A total of 19 studies were selected, most of them were case series (57.9%), cohort studies (31%) and case-control studies (10.5%). A total of 1940 patients. The main indications were anatomical faults, of these failures, recurrent hiatus hernia and sliding occupy the highest percentage, while physiological failures, failure in esophageal and gastric motility occur more frequently.
The main type of approach was laparoscopic in 85%, the conversion rate was 5.3% and the open approach was reserved for complex cases with more than one re-intervention 12.9%, for abdomen 8.6% and chest 3.5%, this last for cases with high esophageal lesions that can not be repaired via trans-abdominal.The main complications were injuries to hollow viscera, such as: esophagus and stomach among others. These complications are related to the complexity of the procedure. Mortality has remained low up to 0.05%, however, the cause of death was due to medical complications and not related to the procedure.

Conclusions: This systematic review on reoperation in reflux surgery has confirmed that mor- bidity after reoperation surgery is higher than after primary surgery and reoperation indications increase with the use of new technologies (manometry) and the laparoscopic approach continues on the rise, with great adaptation to its use and improvement in results.
Summary: The reoperation in antireflux surgery significantly increases morbidity and mor- tality up to 75-85%, reaching rates of 42% in patients undergoing 3 or more surgeries. The advantages of laparoscopic surgery used in this surgical technique have amplified its acceptance and use, resembling its results in terms of feasibility, safety and efficacy of laparoscopic surgery to open surgery.References: 1. MIMI KIM, M.D et al. Minimally invasive RYGB for fdunduplication failure, offers excelente gastroesopageal reflux control-; The American surgeon 7; 80; 2014.
2. Dimitrios Stefanidis; Laroscopic funduplication takedown with conversion to Roux-en-T gastric bypas led to excellent reflux control and quality life in after funduplication failure. Surg Endoscopic 2012 26: 31-35.
3. Farzaneh Bani, MD et al, Laparoscopic reiterative ant reflux surgery: A safe procedure with high patient satisfaction and low morbidity, The American Journal of Surgery 212, 2016, 1115-1120 pp.
4. Hari Nageswaran et al. Laparoscopic redo antireflux surgery: Case-series of different presentations, varied management and their outcomes; International journal of surgery 46:1017, 47-52
5. Sumeet K. Mittal et al. Roux-en-Y reconstruction is superior to redo funduplication in a subset of patients with failed antireflux surgery. Surg Endos 2013; 927- 135 pp
6. Robert C. Tolboom et al. Evaluation of
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