Radiologic and endoscopic characteristics of laparoscopic antireflux wrap: Correlation with outcome

Abstract

After antireflux surgery for gastroesophageal reflux disease, 10% to 15% of patients may have unsuccessful results as a result of abnormal restoration of the esophagogastric junction. The purpose of this study was to evaluate the postoperative endoscopic and radiologic characteristics of the antireflux barrier and their correlation with the postoperative results. After surgery, endoscopic and radiologic features of the antireflux wrap were evaluated in 120 consecutive patients. Jobe's classification of the postoperative valve was used for the definition of a "normal" or "defective"wrap. Patientswere evaluated 3 to 5 years later in order to determine the clinical and objective failed fundoplication. A "normal" antireflux wrapwas associated with successful results in 81.7%of the patients.On the contrary, defective radiologic or endoscopic antireflux wrap was observed in 19% of cases. Among these patients, hypotensive lower esophageal sphincter was observed in 50% to 65% of patients, abno