Results of surgical treatment for recurrent XXXX .

@entity1 @entity355 @entity2910 @entity1066 @entity354
The rate of recurrence of @entity354 after classic antireflux surgery (fundoplication) is 10-15%. This rate is different in @entity1 with @entity2910 with and without @entity355 . We evaluated the clinical and laboratory findings in 104 @entity1 with postoperative recurrent @entity354 , determining the results of repeat antireflux surgery or an acid suppression-bile diversion procedure. Repeat fundoplication was performed in 26 @entity1 , and truncal vagotomy, antrectomy, and Roux-en-Y gastrojejunostomy in 78 @entity1 . Esophagectomy as a third operation was performed in seven @entity1 . After repeat antireflux surgery, endoscopic evaluation demonstrated improvement of @entity2910 in a small proportion of @entity1 . @entity355 remained unchanged, and no regression of @entity1066 or stricture was observed. These complications improved significantly after acid suppression-bile diversion surgery. Incompetent lower esophageal sphincter (LES) was present in 55.8% after initial surgery and in 23% after reoperation. Acid reflux, initially present in 94.6% of @entity1 , was also observed in 93.6% after fundoplication, 68.8% after redo fundoplication, and 16.6% after treatment with the acid suppression-bile diversion technique. A positive Bilitec test was present in 78% of @entity1 before the operation and 56.6% after the repeat operation, and was negative after bile diversion surgery. Among 13 @entity1 (50%) submitted to repeat surgery alone, esophagectomy as a third operation was necessary as a result of severe non-dilatable stricture in seven @entity1 . Our conclusions are that repeat antireflux surgery alone failed to improve @entity355 and that the best results were obtained in @entity1 submitted to acid suppression-bile diversion surgery.
