Publication:

Literature review: revisional anti-reflux surgery

Revision anti-reflux surgery is challenging. With higher rates of complications and lower rates of symptoms control, patient selection is critical. With Roux-en-Y gastrectomy and re-fundoplication being the most commonly performed procedures, there is no clear guidance on operative selection base on patient characteristics.  A literature review was performed of the PubMed database with search terms ‘reflux’, ‘gastrectomy’, and ‘fundoplication’. Of the 164 results, 17 studies were deem suitable for inclusion. In the limited studies available, Roux-en-Y gastrectomy was shown to have higher rates of symptoms control but was also associated with higher rates of complications compared to re-fundoplication. Primary studies assessing the safety and efficacy of gastrectomy as a salvage surgery option are limited. Within the available evidence, select patient groups may benefit from Roux-en-Y gastrectomy over re-fundoplication.