Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Nov;170(5):1295-1303.e1.
doi: 10.1016/j.jtcvs.2025.06.024. Epub 2025 Jun 27.

Analysis of outcomes of reoperative fundoplication in more than 500 patients after failed primary antireflux surgery: Experience over two decades

Dongning Zhang  1 , James Luketich  1 , Claire Collison  1 , Victor Crentsil  1 , Nandini Doshi  1 , Brittany Quattrone  1 , Ryan Levy  1 , Neil Christie  1 , Inderpal Sarkaria  1 , William Gooding  2 , Tadeusz Witek  1 , Omar Awais  1 , Arjun Pennathur  3
Affiliations
Free article

Analysis of outcomes of reoperative fundoplication in more than 500 patients after failed primary antireflux surgery: Experience over two decades

Dongning Zhang et al. J Thorac Cardiovasc Surg. 2025 Nov.
Free article

Abstract

Background: With an increase in the volume of antireflux procedures performed annually, an increasing number of patients with recurrent symptoms after a primary antireflux operation are being referred to thoracic surgeons for complex redo operations. The primary objectives of this study were to evaluate the outcomes of redo fundoplication after failed antireflux operations and to identify risk factors associated with failure of the redo fundoplication.

Methods: We conducted a retrospective review of patients who underwent redo fundoplication. The primary end point evaluated was failure of the redo operation. We also evaluated factors associated with failure of redo fundoplication and postoperative quality of life metrics.

Results: A total of 526 patients underwent redo fundoplication (511 minimally invasive; 97%) after 1 or more prior antireflux operations. Nissen fundoplication was performed in 400 patients (76%), Collis gastroplasty in 165 patients (31%), and partial fundoplication in 126 patients (24%). At a median follow-up of 113 months, 88 patients (17%) had a failure of the redo surgery requiring reoperation. The probability of 5-year failure-free survival was 85% (95% CI, 81-88). In univariate analysis, factors that were significantly associated with failure of the redo fundoplication included age (P = .002), number of redo procedures (P < .001), and type of redo fundoplication (P = .003).

Conclusions: Thoracic surgeons with significant laparoscopic and open esophageal surgical experience can perform minimally invasive, complex redo antireflux procedures safely with good results. Type of fundoplication, age, and number of prior operations are associated with failure of the redo fundoplication. Further work is required to analyze confounding variables to optimize patient selection.

Keywords: GERD; benign disease; esophagus; gastroesophageal reflux; minimally invasive surgery; quality of life; reoperation.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.