PERIOPERATIVE AND SHORT-TERM OUTCOMES AFTER REMEDIAL ANTI-REFLUX SURGERY
K. Mirzaei Baboli*, Sumeet Mittal
Norton Thoracic Institute, Phoenix, AZ
Background: Redo fundoplication (RF) or conversion to Roux-en-Y (RNY) are surgical options for re-operative surgery after failed anti-reflux procedures. The aim of this study was to report and compare perioperative and one-year Gastroesophageal Reflux Disease-Health Related Quality of Life Questionnaire (GERD-HRQL) scores in patients who underwent RF and RNY as remedial surgery.
Methods: After IRB approval, a prospectively maintained esophageal surgery database was retrospectively reviewed to identify patients who underwent redo fundoplication and RNY from September 2016 to July 2020. We retrieved perioperative outcomes (operative time, length of hospital stay, intraoperative and postoperative complications) along with GERD-HRQL scores at annual follow-up.
Results: A total of 58 patients (36 fundoplications and 22 RNY) underwent surgery during the study period. There was no difference in open procedure and conversion rate between groups (fundoplication: 2.8% and RNY: 9%, p=0.292, and fundoplication: 8.3% and RNY: 9%, p=0.921, respectively). There was significantly lower operative time in the RF group (138 '± 43 vs. 172 '± 36 minutes, p= 0.004). The rate of intraoperative complication in the RF group was significantly higher than the RNY group (25% vs. 4.5%, p= 0.045); however, there was no difference in postoperative complications (Clavien-Dindo '‰¥II) between groups (p= 0.806). There was significant and similar improvement of GERD-HRQL scores in both groups at 1 year after surgery (Table 1).
Conclusion: Even with the complexity of the RNY procedure, there was no difference in perioperative parameters between the RNY and RF groups. Both groups showed a high degree of improved GERD-HRQL score at 1-year after surgery.
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