Causes of Failed Reflux Surgery
Patients should be selected very carefully and should have a complete work-up prior to an antireflux procedure.
The majority of failed antireflux procedures are the result of inadequate patient selection, or incomplete diagnostic work-up prior to surgery and failure in surgical techniques.
The fundoplication (wrapping of the stomach around the esophagus) can be:
- too tight
- too lose
- herniated into the chest
- slipped (the stomach is wrapped around itself instead of around the esophagus)
What is a Successful Antireflux Procedure?
Predictors of a successful antireflux procedure include:
- positive esophageal pH study (showing that there is acid inside the esophagus)
- the typical symptoms of reflux, such as heartburn and/or regurgitation
- response to medical therapy
What is a Complete Diagnostic Work-Up?
It is important to review the patient’s symptoms in detail, and to obtain a complete work-up in all patients who are candidate for antireflux surgery, including:
After anti-reflux surgery, if a patient experiences recurrent symptoms (the same symptoms that were present prior to surgery), or new onset reflux-related symptoms, they should see their doctor.