Abstract：
:Fifty patients reoperated for failed Nissen fundoplication are presented; 29 patients (group 2) were operated between 1983 and 1988 while 21 patients (group 1) were operated before 1983. In group 1, the "slipped Nissen" had been the most frequent cause of reoperation (48%). In group 2, the most frequent causes for the unsuccessful operation were: (1) partial or total disruption of the fundic wrap (62%), (2) slipping of the fundoplication, giving rise to the telescope phenomenon (21%), and (3) creation of a fundoplication which was too low (10%). Refundoplication was performed in cases where the dissection of the previously formed fundic wrap was possible (42/50 = 84%). In group 1, three patients were treated by resection of the cardia, one by an Angelchik prosthesis and one by a distal gastric resection with Roux-en-Y diversion. In group 2, fundectomy was performed in one patient; in another, an Angelchik device was inserted, and in a third patient, fundoplication and proximal gastric vagotomy were performed. The results were excellent or good in 66% of patients in group 1 and in 76% of group 2. Operative mortality was 2% and morbidity, 4%. In conclusion, repeat fundoplication is recommended when reestablishment of the fundic region anatomy is possible during dissection. The operation can usually be performed through an abdominal route. Meticulous preoperative evaluation of the patients including 24-hour pH measurement and manometry is necessary. Good results of refundoplication should be expected in 66%-76% of patients with recurrent disease.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Siewert JR,Isolauri J,Feussner Hdoi
10.1007/BF01658439subject
Has Abstractpub_date
1989-11-01 00:00:00pages
791-6; discussion 796-7issue
6eissn
0364-2313issn
1432-2323journal_volume
13pub_type
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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pub_type： 杂志文章
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journal_title：World journal of surgery
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pub_type： 杂志文章
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更新日期：2004-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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pub_type： 杂志文章,评审
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更新日期：2019-03-01 00:00:00
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journal_title：World journal of surgery
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更新日期：1996-09-01 00:00:00
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1994-03-01 00:00:00
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journal_title：World journal of surgery
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更新日期：1992-07-01 00:00:00
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journal_title：World journal of surgery
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更新日期：2012-10-01 00:00:00
