Laparoscopic versus open redo anti-reflux surgery

Mohamed Barkok, Resident at Department of general surgery, Gastrointestinal surgery center, Faculty of Medicine, Mansoura university, Mansoura, EgyptFollow
Mohammed Said, Lecturer at Department of general surgery, Gastrointestinal surgery center,Faculty of Medicine, Mansoura university, Mansoura, Egypt.
Ahmed Shehta, Assistant Professor at Department of general surgery, Gastrointestinal surgery center, Faculty of Medicine, Mansoura university, Mansoura, Egypt
Abdel-Raouf El-Geidie, Professor at Department of general surgery, Gastrointestinal surgery center, Faculty of Medicine, Mansoura university, Mansoura, Egypt. Department of General surgery, Faculty of Medicine, Mansoura university, Mansoura, Egypt.

Corresponding Author

Mohamed Mahmoud Mansour El ghzzawy

Subject Area

General Surgery

Article Type

Original Study

Abstract

Background

Gastroesophageal reflux disease (GERD) is common. Laparoscopic fundoplication became the gold standard for GERD surgery after medical treatment failed. If a previous anti-reflux surgery fails, redo surgery requires a thorough review to determine the cause and a skilled surgical team. Choosing the optimal approach during the redo surgeries, whether open or laparoscopic hasn’t been previously illustrated.

Aim

To compare the outcomes of laparoscopic versus open redo anti-reflux surgeries.

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Patients and methods

This study included 28 patients who underwent redo anti-reflux surgery. The patients were divided according to the approach into laparoscopic (n = 11) and open (n = 17). All patients were assessed preoperatively for demographic data, BMI calculation, detailed history taking, symptoms analysis, endoscopic assessment, and ambulatory PH monitoring. All patients were followed up after the surgery to monitor the early and late postoperative data. Postoperative foregut symptoms were assessed using a standardized foregut symptom severity grading system adapted from Singhal et al. [4]. Dysphagia, regurgitation, heartburn, and chest pain were graded from 0 to 3, where 0 indicated no symptoms, 1 minimal symptoms, 2 moderate symptoms, and 3 severe symptoms. A score of ≥2 was considered clinically relevant. Patient satisfaction was assessed separately using a 10-point subjective satisfaction scale, with a score of ≥8 considered high satisfaction.

Results

The duration of presentation after primary surgery was statistically significantly longer in the open approach group (p = 0.004). The operator degree, as there was a higher operator degree in the open approach group. The duration of hospital stay was statistically significantly longer in the open approach group 3 (2 – 25) as compared to the laparoscopic approach group 3 (2 – 6) (p = 0.026). The development of regurgitation as minimal regurgitation developed in 6 cases (35.3%) in the open approach group, while no cases developed regurgitation in the laparoscopic surgery group.

Conclusion:Laparoscopic and open redo anti-reflux surgery are both efficient. Patients who underwent laparoscopic surgery experienced a shorter hospital stay. Following follow-up, patient satisfaction was equivalent between the two procedures, but regurgitation was greater in the open group.

Recommended Citation

Barkok, Mohamed; Said, Mohammed; Shehta, Ahmed; and El-Geidie, Abdel-Raouf (2026) "Laparoscopic versus open redo anti-reflux surgery," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 19.
Available at: https://doi.org/10.58775/2735-3990.1592