TY - JOUR
T1 - Association of Body Mass Index (BMI) with Patterns of Fundoplication Failure
T2 - Insights Gained
AU - Akimoto, Shunsuke
AU - Nandipati, Kalyana C.
AU - Kapoor, Harit
AU - Yamamoto, Se Ryung
AU - Pallati, Pradeep K.
AU - Mittal, Sumeet K.
PY - 2015/8/5
Y1 - 2015/8/5
N2 - Background: Obesity has been implicated as an important risk factor for fundoplication failure. However, the mechanism of fundoplication in obese patients is not fully understood. Our objective is to evaluate the patterns of failure in relation to the body mass index (BMI) undergoing re-operative intervention after failed fundoplication. Methods: After Institutional Review Board approval, the patients who underwent re-operative intervention for failed fundoplication between November 2008 and December 2013 were identified. Patients were classified into three groups: non-obese, obese, and morbidly obese (35 BMI, respectively). Pre-operative assessment and operative procedure performed were compared between the groups. Results: One hundred twenty-four patients satisfied study criteria. Non-obese patients (53.2 %) had significantly more dysphagia as an indication for re-operative procedure (obese 31.6 %, p <0.05; morbidly 16.7 %, p <0.05). Obese and morbidly obese patients had significantly higher incidence of recurrent hiatal hernia than non-obese patients (88.7 vs. 65.6 %, p <0.05). Morbidly obese patients had significantly higher incidence of disrupted fundoplication than non-obese patients (41.7 vs. 19.4 %, p <0.05). Conclusion: Similar anatomical failure patterns of state of fundoplication and recurrent hiatal hernia were noted between obese patients and morbidly obese patients and were distinct from non-obese patients.
AB - Background: Obesity has been implicated as an important risk factor for fundoplication failure. However, the mechanism of fundoplication in obese patients is not fully understood. Our objective is to evaluate the patterns of failure in relation to the body mass index (BMI) undergoing re-operative intervention after failed fundoplication. Methods: After Institutional Review Board approval, the patients who underwent re-operative intervention for failed fundoplication between November 2008 and December 2013 were identified. Patients were classified into three groups: non-obese, obese, and morbidly obese (35 BMI, respectively). Pre-operative assessment and operative procedure performed were compared between the groups. Results: One hundred twenty-four patients satisfied study criteria. Non-obese patients (53.2 %) had significantly more dysphagia as an indication for re-operative procedure (obese 31.6 %, p <0.05; morbidly 16.7 %, p <0.05). Obese and morbidly obese patients had significantly higher incidence of recurrent hiatal hernia than non-obese patients (88.7 vs. 65.6 %, p <0.05). Morbidly obese patients had significantly higher incidence of disrupted fundoplication than non-obese patients (41.7 vs. 19.4 %, p <0.05). Conclusion: Similar anatomical failure patterns of state of fundoplication and recurrent hiatal hernia were noted between obese patients and morbidly obese patients and were distinct from non-obese patients.
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U2 - 10.1007/s11605-015-2907-z
DO - 10.1007/s11605-015-2907-z
M3 - Article
C2 - 26242886
AN - SCOPUS:84946487001
VL - 19
SP - 1943
EP - 1948
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 11
ER -