PMID- 29899438
OWN - NLM
STAT- MEDLINE
DCOM- 20190909
LR  - 20231006
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 113
IP  - 8
DP  - 2018 Aug
TI  - Complications of Antireflux Surgery.
PG  - 1137-1147
LID - 10.1038/s41395-018-0115-7 [doi]
AB  - Antireflux surgery anatomically restores the antireflux barrier and is a 
      therapeutic option for proton pump inhibitor (PPI)-refractory gastroesophageal 
      reflux disease or PPI intolerance. Laparoscopic fundoplication is the standard 
      antireflux surgery, though its popularity has declined due to concerns regarding 
      wrap durability and adverse events. As the esophagogastric junction is an 
      anatomically complex and dynamic area subject to mechanical stress, wraps are 
      susceptible to disruption, herniation or slippage. Additionally, recreating an 
      antireflux barrier to balance bidirectional bolus flow is challenging, and wraps 
      may be too tight or too loose. Given these complexities it is not surprising that 
      post-fundoplication symptoms and complications are common. Perioperative 
      mortality rates range from 0.1 to 0.2% and prolonged structural complications 
      occur in up to 30% of cases. Upper gastrointestinal endoscopy with a 
      comprehensive retroflexed examination of the fundoplication and barium esophagram 
      are the primary tests to assess for structural complications. Management hinges 
      on differentiating complications that can be managed with medical and lifestyle 
      optimization versus those that require surgical revision. Reoperation is best 
      reserved for severe structural abnormalities and troublesome symptoms despite 
      medical and endoscopic therapy given its increased morbidity and mortality. 
      Though further data are needed, magnetic sphincter augmentation may be a safer 
      alternative to fundoplication.
FAU - Yadlapati, Rena
AU  - Yadlapati R
AD  - University of Colorado, Anschutz Medical Campus, Aurora, CO, USA. Northwestern 
      University, Chicago, IL, USA.
FAU - Hungness, Eric S
AU  - Hungness ES
AD  - University of Colorado, Anschutz Medical Campus, Aurora, CO, USA. Northwestern 
      University, Chicago, IL, USA.
FAU - Pandolfino, John E
AU  - Pandolfino JE
AD  - University of Colorado, Anschutz Medical Campus, Aurora, CO, USA. Northwestern 
      University, Chicago, IL, USA.
LA  - eng
GR  - R01 DK092217/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
DEP - 20180614
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
SB  - IM
MH  - Decision Trees
MH  - Digestive System Surgical Procedures/adverse effects
MH  - Fundoplication/adverse effects
MH  - Gastroesophageal Reflux/*surgery
MH  - Humans
MH  - Laparoscopy/adverse effects
MH  - Postoperative Complications/etiology
PMC - PMC6394217
MID - NIHMS1004779
COIS- Conflicts of Interest: RY: Consultant for Ironwood; JEP: Consultant for Crospon, 
      Ironwood, Torax, Astra Zeneca, Takeda, Impleo, Medtronic, Sandhill; ESH: 
      Consultant for Baxter, Boston Scientific
EDAT- 2018/06/15 06:00
MHDA- 2019/09/10 06:00
PMCR- 2019/08/01
CRDT- 2018/06/15 06:00
PHST- 2018/02/03 00:00 [received]
PHST- 2018/04/11 00:00 [accepted]
PHST- 2018/06/15 06:00 [pubmed]
PHST- 2019/09/10 06:00 [medline]
PHST- 2018/06/15 06:00 [entrez]
PHST- 2019/08/01 00:00 [pmc-release]
AID - 10.1038/s41395-018-0115-7 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2018 Aug;113(8):1137-1147. doi: 10.1038/s41395-018-0115-7. 
      Epub 2018 Jun 14.