Surgical treatment of symptomatic gastroesophageal reflux recurring after XXXX repair.

@entity1 @entity2910 @entity532 @entity357 @entity547 @entity850
Experience of 30 cases with reoperation for recurrent symptoms after @entity357 repair is reported. The primary operation had been transabdominal in 21 cases (11 simple cruroplasty, 7 Nissen, 3 Hill) and transthoracic in 9 (5 Husfeldt, 4 simple cruroplasty). @entity850 and/or esophageal shortening were present in at least 8 @entity1 at the primary operation. Symptoms recurred within a year in 26 of the 30 @entity1 . A transthoracic approach was used for all reoperations. At the time of reoperation, 14 @entity1 had no @entity532 or had @entity2910 only. At follow-up (2-12 years) 13 were symptom-free and 1 was improved: X-ray showed @entity547 in one case and 3 had positive standard reflux test. Of the 16 @entity1 with severe @entity532 before reoperation, 12 had shortened esophagus, combined with stricture in 6 cases, and 4 had isolated stricture. The results were less satisfactory in this complicated group, though all were postoperatively improved. There was no operative mortality. Initial failure to recognize esophageal shortening and inadequate repair were common causes of recurrent @entity547 . Symptomatic relief after reoperation was comparable with that after primary repair.
