BACKGROUND: One of the most frequent complications after laparoscopic antireflux surgery is estimated to be the intrathoracic herniation of the wrap into the chest. Therefore, in up to 5% of @entity1 , revisional surgery is necessary. HYPOTHESIS: @entity1 who undergo laparoscopic refundoplication for postoperative @entity13209 using a circular polypropylene mesh for hiatal closure have a good to excellent functional outcome, during a complete follow-up of 1 year. DESIGN: Prospective nonrandomized trial of a consecutive sample. SETTING: University-affiliated community hospital. @entity1 : Twenty-four @entity1 undergoing laparoscopic refundoplication for persistent or recurrent symptoms of @entity354 as a result of postoperative intrathoracic wrap migration. INTERVENTION: All @entity1 underwent laparoscopic refundoplication with a circular polypropylene mesh for hiatal closure. MAIN OUTCOME MEASURES: Recurrences, complications, postoperative lower esophageal sphincter pressure, DeMeester score, esophagogastroduodenoscopy results, and barium swallow results. RESULTS: All refundoplications were completed laparoscopically. There were no intraoperative complications. Twenty-one @entity1 underwent laparoscopic Nissen fundoplication; in 3 @entity1 , a laparoscopic Toupet fundoplication was performed. Previous antireflux procedures included an open Nissen fundoplication (n = 5), a laparoscopic Nissen fundoplication (n = 15), and a laparoscopic Toupet fundoplication (n = 4). Postoperatively, one @entity1 had severe @entity1282 and had to undergo pneumatic dilatation once. During a follow-up of 1 year after surgery, no @entity1 developed a recurrent @entity357 , with or without @entity13209 . The mean lower esophageal sphincter pressure increased significantly (P<.01) at 3 months (12.2 mm Hg) and 1 year (11.9 mm Hg) after refundoplication. The mean DeMeester score decreased significantly (P<.01) from 50.5 points preoperatively to 16.0 points at 3 months and 14.7 points at 1 year after refundoplication. CONCLUSION: Laparoscopic refundoplication with prosthetic hiatal closure is a safe and effective procedure for preventing recurrent @entity13209 , with good to excellent functional outcome for a complete follow-up of 1 year.

Laparoscopic refundoplication with prosthetic hiatal closure for recurrent XXXX after primary failed antireflux surgery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity13209 :: ('MESH:D006045', 'Disease') :: ['intrathoracic wrap herniation'] @entity357 :: ('MESH:D006551', 'Disease') :: ['hiatal hernia'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux disease']
@entity357 :: (MESH:D006551,Disease) :: ['hiatal hernia']
