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); fun duplication (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 for failed antireflux surgery, this seems to be an alternative for recurrent reflux esophagitis in patients who have not responded to adequate medical treatment.