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Sökning: onr:"swepub:oai:DiVA.org:uu-364188" > Evaluation of resec...

Evaluation of resection of the gastroesophageal junction and jejunal interposition (Merendino procedure) as a rescue procedure in patients with a failed redo antireflux procedure. A single-center experience

Analatos, Apostolos (författare)
Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden; Nykoping Hosp, Dept Surg, Nykoping, Sweden
Lindblad, Mats (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Rouvelas, Ioannis (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
visa fler...
Elbe, Peter (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Lundell, Lars (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Nilsson, Magnus (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Tsekrekos, Andrianos (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Tsai, Jon A. (författare)
Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden; Karolinska Inst, Dept Clin Intervent & Technol CLINTEC, Div Surg, Stockholm, Sweden
Tsai, JA (författare)
Karolinska Institutet
Lindblad, M (författare)
Karolinska Institutet
Elbe, P (författare)
Karolinska Institutet
Nilsson, M (författare)
Karolinska Institutet
Analatos, A (författare)
Karolinska Institutet
Rouvelas, I (författare)
Karolinska Institutet
Lundell, L (författare)
Karolinska Institutet
Tsekrekos, A (författare)
Karolinska Institutet
visa färre...
 (creator_code:org_t)
2018
2018
Engelska.
Ingår i: BMC Surgery. - 1471-2482 .- 1471-2482. ; 18
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Background: Primary antireflux surgery has high success rates but 5 to 20% of patients undergoing antireflux operations can experience recurrent reflux and dysphagia, requiring reoperation. Different surgical approaches after failed fundoplication have been described in the literature. The aim of this study was to evaluate resection of the gastroesophageal junction with jejunal interposition (Merendino procedure) as a rescue procedure after failed fundoplication.Methods: All patients who underwent a Merendino procedure at the Karolinska University Hospital between 2004 and 2012 after a failed antireflux fundoplication were identified. Data regarding previous surgical history, preoperative workup, postoperative complications, subsequent investigations and re-interventions were collected retrospectively. The follow-up also included questionnaires regarding quality of life, gastrointestinal function and the dumping syndrome.Results: Twelve patients had a Merendino reconstruction. Ten patients had undergone at least two previous fundoplications, of which one patient had four such procedures. The main indication for surgery was epigastric and radiating back pain, with or without dysphagia. Postoperative complications occurred in 8/12 patients (67%). During a median follow-up of 35 months (range 20-61), four (25%) patients had an additional redo procedure with conversion to a Roux-en-Y esophagojejunostomy within 12 months, mainly due to obstructive symptoms that could not be managed conservatively or with endoscopic techniques. Questionnaires scores were generally poor in all dimensions.Conclusions: In our experience, the Merendino procedure seems to be an unsuitable surgical option for patients who require an alternative surgical reconstruction due to a failed fundoplication. However, the small number of patients included in this study as well as the small number of participants who completed the postoperative workout limits this study.

Ämnesord

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

Gastroesophageal reflux
Reoperation
Quality of life
Jejunal interposition
Merendino procedure

Publikations- och innehållstyp

ref (ämneskategori)
art (ämneskategori)

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