Details

Autor(en) / Beteiligte

• Haso, A
• Hashim, D
• Meyer, F
• García-Ureña, M A
• Albayrak, N

Titel

OC-080 A NOVEL SURGICAL APPROACH, THE DOUBLE TRACT RECONSTRUCTION IN TREATING FAILED RE-DO FUNDOPLICATION

Ist Teil von

• British journal of surgery, 2023-05, Vol.110 (Supplement_2)

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2023

Link zum Volltext

Beschreibungen/Notizen

• Abstract Aim Recurrence of hiatal hernia may occur in up to 70% of patients. Failure is defined subjectively as recurrence of symptoms and objectively by imaging or pH studies, which can diagnose recurrent hiatal hernia, wrap disruption, and/or reflux disease. Approximately 25% of patients need partial or subtotal esophagectomy - mainly secondarily to scar formation and fibrosis at the hiatus site. Our aim is to report the early results of a novel double tract reconstruction in treating failed re-do fundoplication Materials and methods Retrospective review of prospectively collected data on patients who had undergone salvage operation of failed re-do fundoplication related to demographics, operative details, surgical and clinical outcomes as well as patient satisfaction. Results Overall: 9 patients underwent double tract reconstruction in the last 3 years, 6 of them had undergone a re-do fundoplication, two had the 1st recurrent hiatal hernia and one individual had complication after LINX system application. In detail: All patients underwent laparoscopic transhiatal distal esophagus resection including proximal gastric resection with double-tract reconstruction (Roux-en-Y esophagojejunostomy with gastrojejunostomy). Mean operating time was 346 min. Mean hospital stay was 12.5 d. Outcome: There were no 30-d reoperation and no 30-d readmission. One female reported repeated abdominal pain and vomiting with weight loss. She underwent psychotherapy with additional gastric feeding temporarily. Conclusion Double tract reconstruction appears a suitable option in treating symptomatic recurrently failed hiatal hernia repair especially after the second or third recurrence with disruption of the anatomy and scarring of gastroesophageal junction.