Persistent dysphagia after laparoscopic fundoplication for gastro-esophageal reflux disease

Uberto Fumagalli, S. Bona, F. Battafarano, M. Zago, R. Barbera, R. Rosati

Research output: Contribution to journalArticle

Abstract

Persistent postoperative dysphagia is a potentially severe complication of fundoplication for gastroesophageal reflux disease (GERD). The aim of this retrospective study was to analyze our experience of laparoscopic fundoplication for GERD in 276 consecutive patients, to determine the frequency of postoperative dysphagia and assess treatments and outcomes. There was no relation between preoperative dysphagia, present in 24 patients (8.7%), and postoperative DeMeester grade 2 or 3 dysphagia, present in 25 patients (9.1%). Ten (3.6%) patients had clinically significant postoperative dysphagia, eight (2.9%) underwent esophageal dilation, with symptom improvement in five. Four (1.4%) of our patients (two with failed dilation) and 11 patients receiving antireflux surgery elsewhere, underwent re-operation for persistent dysphagia 12 months (median) after the first operation. DeMeester grade 0 or 1 dysphagia was obtained in 10/13 evaluable patients. Our experience is fully consistent with that of the recent literature. Redo surgery is necessary in only a small fraction of operated patients with GERD with good probability of resolving the dysphagia. Best outcomes are obtained when an anatomical cause of the dysphagia is documented preoperatively.

Original languageEnglish
Pages (from-to)257-261
Number of pages5
JournalDiseases of the Esophagus
Volume21
Issue number3
DOIs
Publication statusPublished - May 2008

    Fingerprint

Keywords

  • Antireflux surgery
  • Gastro-esophageal reflux disease (GERD)
  • Laparoscopic fundoplication
  • Postoperative dysphagia

ASJC Scopus subject areas

  • Gastroenterology

Cite this