{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:14:58Z","timestamp":1760188498133},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[1989,11,1]],"date-time":"1989-11-01T00:00:00Z","timestamp":625881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1989,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fifty patients reoperated for failed Nissen fundoplication are presented; 29 patients (group 2) were operated between 1983 and 1988 while 21 patients (group 1) were operated before 1983. In group 1, the \u201cslipped Nissen\u201d had been the most frequent cause of reoperation (48%). In group 2, the most frequent causes for the unsuccessful operation were: (1) partial or total disruption of the fundic wrap (62%), (2) slipping of the fundoplication, giving rise to the telescope phenomenon (21%), and (3) creation of a fundoplication which was too low (10%). Refundoplication was performed in cases where the dissection of the previously formed fundic wrap was possible (42\/50=84%). In group 1, three patients were treated by resection of the cardia, one by an Angelchik prosthesis and one by a distal gastric resection with Roux\u2010en\u2010Y diversion.<\/jats:p><jats:p>In group 2, fundectomy was performed in one patient; in another, an Angelchik device was inserted, and in a third patient, fundoplication and proximal gastric vagotomy were performed. The results were excellent or good in 66% of patients in group 1 and in 76% of group 2. Operative mortality was 2% and morbidity, 4%.<\/jats:p><jats:p>In conclusion, repeat fundoplication is recommended when reestablishment of the fundic region anatomy is possible during dissection. The operation can usually be performed through an abdominal route. Meticulous preoperative evaluation of the patients including 24\u2010hour pH measurement and manometry is necessary. Good results of refundoplication should be expected in 66%\u201376% of patients with recurrent disease.<\/jats:p>","DOI":"10.1007\/bf01658439","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T12:53:49Z","timestamp":1115556829000},"page":"791-796","source":"Crossref","is-referenced-by-count":66,"title":["Reoperation following failed fundoplication"],"prefix":"10.1002","volume":"13","author":[{"given":"J. R\u00fcdiger","family":"Siewert","sequence":"first","affiliation":[{"name":"Department of Surgery Technical University of Munich Klinikum rechts der Isar Ismaninger Stra\u00dfe 22 8000 M\u00fcnchen 80 Federal Republic of Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jouko","family":"Isolauri","sequence":"additional","affiliation":[{"name":"Department of Surgery Technical University of Munich Klinikum rechts der Isar Ismaninger Stra\u00dfe 22 8000 M\u00fcnchen 80 Federal Republic of Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubertus","family":"Feussner","sequence":"additional","affiliation":[{"name":"Department of Surgery Technical University of Munich Klinikum rechts der Isar Ismaninger Stra\u00dfe 22 8000 M\u00fcnchen 80 Federal Republic of Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1989,11]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"590","article-title":"Eine einfache Operation zur Beeinflussung der Reflux\u00f6sophagitis","volume":"86","author":"Nissen R.","year":"1956","journal-title":"Schweiz Med. 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