REOPERATIONS AFTER FAILURE OF ANTIREFLUX SURGERY

We present 28 patients who underwent surgery after failed procedures d ue to gastroesophageal reflux with an asymptomatic period over 2.6 yea rs, The most frequent complications resulted in recurrent reflux (86%) and peptic strictures (36%). An abdominal approach was used on all th e patients. Reoperation, using the Collis-Nissen gastroplasty (19 case s), Nissen 360 degrees (3 cases), duodenal diversion with Roux-en-Y (3 cases) and Angelchick prothesis (3 cases) gave excellent or good resu lts in 84% of the patients and poor in 4 cases. There was one operativ e death. All patients were referred for 24 hour pH-monitoring. Sphinct er pressure and length of the distal esophageal sphincter were signifi cantly increased over the preoperative values. Our results suggest tha t the Collis Nissen procedure is a suitable form of treatment for comp licated forms of peptic esophagitis after the failed antireflux operat ions.