Clinical and laboratory characteristics and surgical alternatives in patients with postoperative recurrent reflux esophagitis

Abstract

The recurrence of reflux esophagitis after antireflux surgery ranges between 5 and 25% according to the technique employed. The clinical, laboratory findings and the surgical alternatives were analyzed in patients with recurrent reflux esophagitis. Fifty-two patients were included in the study. All patients presented heartburn; 62% of them had a hypotensive lower esophageal sphincter and gastrophageal reflux was present in 97% of cases. Alkaline reflux was also assessed. Endoscopic results demonstrated severe esophagitis in about half the patients. Reoperations were performed 3 or more years after the first operation in almost 90% of cases. The patients were submitted to: recalibration of cardia with posterior gastropexy (19 patients); fundoplication (5 cases); partial distal gastrectomy with Roux-en-Y gastrojejunostomy (25 patients), and esophagectomy with colon interposition in 3 cases. Mortality was 5.8%. Despite the surgical difficulties and morbimortality rate after reoperation fo